Clinical Research Directory

Comparison of the Need Of Mechanical Ventilation Between Less Invasive Surfactant Administration (LISA) and Conventional INSURE (Intubation-Surfactant Administration-Extubation) Methods in Spontaneously Breathing Preterm Infants With Respiratory Distress Syndrome

\*\*Brief Summary of the Study\*\* This randomized controlled trial aims to compare the need for mechanical ventilation between Less Invasive Surfactant Administration (LISA) and the conventional INSURE (Intubation, Surfactant Administration, and Extubation) method in spontaneously breathing preterm infants with respiratory distress syndrome. The study will be conducted in the Department of Neonatology, Sir Ganga Ram Hospital, Lahore, Pakistan, with a total sample size of 90 preterm infants born before 35 weeks of gestation. Participants will be allocated to either the LISA group or the INSURE group, with 45 infants in each group. The primary outcome will be the need for mechanical ventilation following surfactant administration, assessed within three hours of treatment. Data will be analyzed using SPSS version 25.0, with the chi-square test used to compare the need for mechanical ventilation between the two groups. The findings are expected to help identify the more effective surfactant administration method in reducing the need for mechanical ventilation in preterm infants with respiratory distress syndrome.

Heated, Humidified High-flow Nasal (HHHFN) Cannula vs Nasal Continuous Positive Airway Pressure in Respiratory Distress in Premature Neonates

Newborn babies who have difficulty breathing may need breathing support to help them receive enough oxygen. Two commonly used methods are heated, humidified high-flow nasal cannula (HHFNC), which delivers warmed, moist air and oxygen through small tubes in the nose, and nasal continuous positive airway pressure (nCPAP), which helps keep the lungs open by delivering air and oxygen under gentle pressure through a nasal mask or tubes. This study will compare these two methods in newborn babies born at 28 weeks of pregnancy or later who develop breathing difficulties within the first 24 hours after birth. The study will be conducted in the neonatal intensive care unit at PAF Hospital Islamabad and will include 100 newborn babies. Participants will be randomly assigned to receive either HHFNC or nCPAP as their initial breathing support. The main purpose is to compare how often each method fails to provide adequate breathing support within the first 72 hours, requiring a change to another form of breathing support or insertion of a breathing tube for mechanical ventilation. The study will also assess other outcomes, including nasal injury, survival until hospital discharge, need for surfactant treatment, duration of breathing support and oxygen therapy, time to achieve full feeding, intestinal complications, and length of hospital stay. The findings may help improve understanding of the effectiveness and safety of these two breathing support methods in newborn babies with breathing difficulties.

Higher-Dose Dexamethasone Improves Breathing and Shortens NICU Stay in Preterm Babies

The goal of this observational study was to compare two doses of dexamethasone given to pregnant women at risk of preterm birth. Dexamethasone is a medicine used before birth to help a baby's lungs mature. This study looked at preterm babies born between 26 and 36 weeks of pregnancy. Researchers compared babies whose mothers received dexamethasone 12 mg every 12 hours for 48 hours with babies whose mothers received dexamethasone 6 mg every 12 hours for 48 hours. The main questions this study aimed to answer were: * Did the higher dose of dexamethasone help preterm babies need breathing support for a shorter time? * Did the higher dose help shorten the babies' stay in the Neonatal Intensive Care Unit (NICU)? * Was the higher dose as safe as the lower dose for babies and mothers? Researchers reviewed medical records from Stella Maris Women's and Children's Hospital from January 2018 to January 2023. They looked at neonatal outcomes, including breathing support, respiratory distress syndrome, length of NICU stay, low blood sugar in babies, infection in mothers, and developmental problems at 24 months.

MINImising Total Radiation EXposure in Preterm Infants

Being born too early (preterm birth) is the leading cause of death in children world-wide. In Australia, 97% of very preterm babies who are admitted to Neonatal Intensive Care Units need breathing support after birth to survive. Despite this significant global impact, neonatal clinicians have few tools available to guide breathing support. Currently, the only lung imaging tool that is routinely used in the Neonatal Intensive Care Unit is a chest X-ray. To reduce radiation exposure, chest X-rays are usually only performed one or two times a day. As chronic lung disease in babies who survive preterm birth is increasing, there is an urgent need to develop new ways to monitor the lungs of these fragile babies. Lung ultrasound is a form of imaging that is fast, gentle and radiation free. However, it has not been routinely adopted into caring for preterm babies in most countries. This is because there are no randomised controlled trials that have demonstrated the benefit and safety of using lung ultrasound as the first-line imaging tool in preterm babies. The investigators will conduct a randomised controlled trial to demonstrate that lung ultrasound is a quick, safe and accurate alternative to chest x-rays in preterm babies.

To Investigate the Effect of Pulmonary Surfactant With Different Inspired Oxygen Concentrations on the Clinical Outcomes of Very Preterm Infants Under Non-invasive Assisted Ventilation

A prospective multicenter randomized controlled study was conducted. Eligible very preterm infants with a gestational age of \<32 weeks were enrolled. All infants received routine treatment after birth and were randomly divided into two groups according to the FiO2 threshold of PS under noninvasive assisted ventilation: Control group (FiO2=0.30) and low concentration group (FiO2=0.25). Clinical data were collected to explore the differences in clinical outcomes between the two groups.

Assessment Of Dose-Dependent Immunomodulatory Effect Of Alveofact With or Without Steroisd In Neonatal RDS

An Exploratory Randomized double-arm controlled trial to evaluate the immunomodulatory effect of low versus high dose of Alveofact with or without Budesonide.