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Trial registered on ANZCTR
Registration number
ACTRN12611000628943
Ethics application status
Approved
Date submitted
20/06/2011
Date registered
21/06/2011
Date last updated
2/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Is bias gas flow in ventilated preterm babies related to lung injury and risk of bronchopulmonary dysplasia?
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Scientific title
Ventilator bias gas flows in extremely preterm or extremely low birth weight babies: does a low bias gas flow compared with standard settings decrease concentrations of IL-8 in tracheal secretions and blood and the number of ventilated days?
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Secondary ID [1]
262412
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Nil
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Universal Trial Number (UTN)
U1111-1122-3024
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Trial acronym
FLoRa: Flows at Lower Rates
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
ventilator-induced lung injury
268107
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Bronchopulmonary dysplasia
268108
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Extreme preterm birth
268110
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Extremely low birth weight
268111
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Condition category
Condition code
Respiratory
268250
268250
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0
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Other respiratory disorders / diseases
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Reproductive Health and Childbirth
268254
268254
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0
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Complications of newborn
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1:Conventional ventilation via ETT at a bias gas flow of 4 L/min
Arm 2: Conventional ventilation via ETT at a bias gas flow of 10 L/min
Duration; each time ventilation is indicated up to 36 weeks’ corrected gestational age
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Intervention code [1]
266792
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Treatment: Devices
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Comparator / control treatment
Standard treatment of ventilation at a bias gas flow of 10 L/min
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Control group
Active
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Outcomes
Primary outcome [1]
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Level of IL-8 in tracheal aspirate
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Assessment method [1]
268977
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Timepoint [1]
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Assessed at 24 hours after onset of ventilation
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Primary outcome [2]
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Number of ventilated days
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Assessment method [2]
268978
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Timepoint [2]
268978
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discharge from neonatal intensive care unit or death
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Secondary outcome [1]
276739
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Levels of inflammatory markers IL-8, IL1-beta, IL-6 and TNF-alpha and levels of the oxidative stress markers myeloperoxidase activity, glutathione sulfonamide and chlorotyrosine in blood and tracheal aspirate
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Assessment method [1]
276739
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Timepoint [1]
276739
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Assessed at 24, 72 and 120 hours after onset of ventilation
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Secondary outcome [2]
276740
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Bronchopulmonary dysplasia
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Assessment method [2]
276740
0
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Timepoint [2]
276740
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36 weeks corrected postmenstrual age
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Secondary outcome [3]
276741
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mRNA Levels of early response genes CYR61, CTGF and EGR1 in blood samples, measured by molecular analysis
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Assessment method [3]
276741
0
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Timepoint [3]
276741
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Assessed at 24, 72 and 120 hours after onset of ventilation
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Secondary outcome [4]
276742
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Composite outcome of death or neonatal morbidity, including pulmonary interstitial emphysema, pulmonary haemorrhage, intraventricular haemorrhage (grade III and IV), periventricular leukomalacia, retinopathy of prematurity, necrotising enterocolitis or persistent ductus arteriosus.
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Assessment method [4]
276742
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Timepoint [4]
276742
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36 weeks corrected postmenstrual age or death
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Secondary outcome [5]
276743
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Occurrence of asthma or wheezing assessed by history and prescription of bronchodilators or inhaled corticosteroids
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Assessment method [5]
276743
0
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Timepoint [5]
276743
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2 years
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Eligibility
Key inclusion criteria
Preterm baby born before 28 weeks of gestation or birth weight < 1,000 g and the need for mechanical ventilation in the first week of life
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Minimum age
0
Days
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Maximum age
7
Days
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Congenital cardio-respiratory anomalies and known chromosomal or genetic abnormalities
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation from random number table stratified by centre
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/09/2011
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Actual
27/07/2012
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
180
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3631
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New Zealand
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State/province [1]
3631
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Auckland
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Country [2]
3632
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New Zealand
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State/province [2]
3632
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Christchurch
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Funding & Sponsors
Funding source category [1]
267261
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Charities/Societies/Foundations
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Name [1]
267261
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Anonymous philanthropic donation
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Address [1]
267261
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C/- Liggins Institute
University of Auckland
Private Bag 92019
Auckland 1142
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Country [1]
267261
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New Zealand
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Funding source category [2]
289023
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Charities/Societies/Foundations
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Name [2]
289023
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Cure Kids
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Address [2]
289023
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PO Box 90-907
Victoria Street West
Auckland, 1142
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Country [2]
289023
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New Zealand
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Funding source category [3]
289024
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Charities/Societies/Foundations
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Name [3]
289024
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A+ Charitable trust fund
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Address [3]
289024
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ADHB
Private bag 92024
Auckland 1142
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Country [3]
289024
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Liggins Institute
University of Auckland
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
266324
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Hospital
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Name [1]
266324
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Auckland City Hospital
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Address [1]
266324
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Newborn Services
National Women's Health
Auckland City Hospital
Support Building, level 9
PO Box 92024
Auckland 1023
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Country [1]
266324
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New Zealand
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Other collaborator category [1]
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University
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Name [1]
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University of Otago
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Address [1]
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Department of Paediatrics
Christchurch Clinical School, University of Otago
P.O. Box 4345, Level 5, 2 Riccarton Avenue, Christchurch 8140
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Country [1]
252066
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New Zealand
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Other collaborator category [2]
252067
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Hospital
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Name [2]
252067
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Royal Women's Hospital
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Address [2]
252067
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Royal Women's Hospital
Flemington Road
Parkville
Melbourne
Victoria 3050
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Country [2]
252067
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
269256
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Multi-region ethics committee
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Ethics committee address [1]
269256
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Ethics committee country [1]
269256
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New Zealand
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Date submitted for ethics approval [1]
269256
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01/07/2011
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Approval date [1]
269256
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29/08/2011
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Ethics approval number [1]
269256
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MEC11/08/068
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Summary
Brief summary
Mechanical ventilation of preterm babies has increased their survival over the last decades; however, ventilation also results in injury to the delicate immature lung. Several aspects of ventilation have been identified as contributing to this injury, including the pressure generated by the ventilator and the volume of gas delivered, which have led to advances in ventilatory strategies. To generate the pressure and tidal volume necessary to ventilate a patient, a ventilator applies a continuous bias gas flow running through the ventilator circuit. During ventilation of the preterm baby, this bias gas flow is normally set at 8-10 L/min, independent of babies’ weights and without evidence for this to be the correct setting. However, high compared to low ventilator bias gas flows have been proven to be more injurious for the immature lamb lung. This study will compare preterm babies ventilated at either the standard gas flow of 10 L/min, or a low gas flow of 4 L/min. Outcomes will be measurement of levels of inflammatory markers and duration and intensity of respiratory support
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
32756
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Dr Katinka Bach
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Address
32756
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Newborn Services
Auckland City Hospital
Support Building level 9
Private bag 92024
Auckland 1023
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Country
32756
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New Zealand
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Phone
32756
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+64 9 307 4949, ext 23526
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Fax
32756
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Email
32756
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[email protected]
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Contact person for public queries
Name
16003
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Dr Katinka Bach
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Address
16003
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Newborn Services, Auckland City Hospital
Support Building, level 9
PO Box 92024
Auckland 1023
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Country
16003
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New Zealand
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Phone
16003
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+64 21 064 3439
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Fax
16003
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+64 9 3754373
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Email
16003
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[email protected]
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Contact person for scientific queries
Name
6931
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Frank Bloomfield
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Address
6931
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Liggins Institute
University of Auckland
Private Bag 92019
Auckland 1142
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Country
6931
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New Zealand
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Phone
6931
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+64 9 9236107
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Fax
6931
0
+64 9 3737497
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Email
6931
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF