Clinical Trial for the Evaluation of Customized 3D Printed NIV Nasal Masks in Premature Infants

Premature Lungs Clinical Trial

— M3DPREMAT  

Official title:

Clinical Trial to Assess the Clinical Impact, Efficacy and Safety of Customized Nasal Masks Designed by 3D Printing During Non-invasive Ventilation in Premature Infants

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06224816
• Other study ID #: M3DPREMAT
• Status: Recruiting
• Phase: N/A
• Start date: April 16, 2024
• Est. completion date: December 2026

Study information

• Verified date: April 2024
• Source: Hospital Universitario 12 de Octubre
• Contact: María Teresa Moral Pumarega
• Phone: 649921733
• Email: mmoralp[@]salud.madrid.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Clinical trial with crossed groups, open, masked for the evaluation of the main outcome. Inclusion of all premature infants with a birth weight less than 1500 g requiring Non-invasive Ventilation (NIV).

Premature will be randomised to start alternatively with MT or 3DM. Each patient included will be their own control at the same time, receiving each of the different mask models every 4 hours alternately. The study period will be a maximum of 7 days.

To compare the time in which preterm maintain SatO2 below 85% with the 3DM versus the traditional mask (TM) in preterm < 1500 g. Other secondary objectives regarding ventilation enhancement will be assessed, such as the number of bradycardias, cardiorespiratory arrest and need for resuscitation in the context of apnea. Also, skin lesions of the nose resulting from the pressure applied by any of the masks (TM or 3DM) and the need for analgesia and/or sedation for pain control or discomfort will be assessed. Parental perception and satisfaction will be assessed.

Description:

Improvement and optimization of non-invasive ventilation (NIV) in preterm and low birth weight infants is essential in order to reduce morbidity. By the use of 3D printing design (3DM), these infants would be provided with customized nasal masks, according to their particular anatomical features while on NIV. This would lead to a greater stabilization of the respiratory system, decreased apnea spells, oxygen desaturation and bradycardia, less need for intubation and less skin nose injury, all of which might improve neurodevelopmental outcomes.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: December 2026
• Est. primary completion date: December 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 0 Days to 30 Days

Eligibility

Inclusion Criteria:

• Newborn prematurity

• Age: less than 30 days of life

• Required respiratory support with non-invasive ventilation (NIV)

• Premature infant has not been on NIV for more than 3 days before being included in the trial.

• Signature of the Informed Consent (IC)

Exclusion Criteria:

• Failure to meet entry criteria

• Cyanotic congenital heart disease diagnosis

• Presence of serious malformations

• Presence of airway malformations

Related Conditions & MeSH terms

• Premature Birth
• Premature Lungs

Intervention

Device:
• Custom 3D mask (3DM) application in neonate
Premature infants with a birth weight less than 1500 g r first received 3D mask during 4 hour, then crossed over to traditional mask.
• Traditional mask (TM) application in neonate
Premature infants with a birth weight less than 1500 g r first received traditional mask during 4 hours, then crossed over to 3D mask.

Locations

Country	Name	City	State
Spain	Hospital Universitario 12 de Octubre	Madrid

Sponsors (2)

Lead Sponsor	Collaborator
Hospital Universitario 12 de Octubre	ISCIII

Country where clinical trial is conducted

Spain, 

References & Publications (17)

Al-Ramahi J, Luo H, Fang R, Chou A, Jiang J, Kille T. Development of an Innovative 3D Printed Rigid Bronchoscopy Training Model. Ann Otol Rhinol Laryngol. 2016 Dec;125(12):965-969. doi: 10.1177/0003489416667742. Epub 2016 Sep 7. — View Citation

Bhattacharjee N, Parra-Cabrera C, Kim YT, Kuo AP, Folch A. Desktop-Stereolithography 3D-Printing of a Poly(dimethylsiloxane)-Based Material with Sylgard-184 Properties. Adv Mater. 2018 May;30(22):e1800001. doi: 10.1002/adma.201800001. Epub 2018 Apr 14. — View Citation

Bose CL, Dammann CE, Laughon MM. Bronchopulmonary dysplasia and inflammatory biomarkers in the premature neonate. Arch Dis Child Fetal Neonatal Ed. 2008 Nov;93(6):F455-61. doi: 10.1136/adc.2007.121327. Epub 2008 Aug 1. — View Citation

Clarke A, Yeomans E, Elsayed K, Medhurst A, Berger P, Skuza E, Tan K. A randomised crossover trial of clinical algorithm for oxygen saturation targeting in preterm infants with frequent desaturation episodes. Neonatology. 2015;107(2):130-6. doi: 10.1159/000368295. Epub 2014 Dec 12. — View Citation

Duong K, Glover J, Perry AC, Olmstead D, Ungrin M, Colarusso P, MacLean JE, Martin AR. Feasibility of three-dimensional facial imaging and printing for producing customised nasal masks for continuous positive airway pressure. ERJ Open Res. 2021 Feb 1;7(1):00632-2020. doi: 10.1183/23120541.00632-2020. eCollection 2021 Jan. — View Citation

Hadeed K, Dulac Y, Acar P. Three-dimensional printing of a complex CHD to plan surgical repair. Cardiol Young. 2016 Oct;26(7):1432-4. doi: 10.1017/S1047951116000755. Epub 2016 Jun 20. — View Citation

Hinton TJ, Hudson A, Pusch K, Lee A, Feinberg AW. 3D Printing PDMS Elastomer in a Hydrophilic Support Bath via Freeform Reversible Embedding. ACS Biomater Sci Eng. 2016 Oct 10;2(10):1781-1786. doi: 10.1021/acsbiomaterials.6b00170. Epub 2016 May 4. — View Citation

Kamath AA, Kamath MJ, Ekici S, Stans AS, Colby CE, Matsumoto JM, Wylam ME. Workflow to develop 3D designed personalized neonatal CPAP masks using iPhone structured light facial scanning. 3D Print Med. 2022 Aug 1;8(1):23. doi: 10.1186/s41205-022-00155-7. — View Citation

Minocchieri S, Burren JM, Bachmann MA, Stern G, Wildhaber J, Buob S, Schindel R, Kraemer R, Frey UP, Nelle M. Development of the premature infant nose throat-model (PrINT-Model): an upper airway replica of a premature neonate for the study of aerosol delivery. Pediatr Res. 2008 Aug;64(2):141-6. doi: 10.1203/PDR.0b013e318175dcfa. — View Citation

Roh S, Parekh DP, Bharti B, Stoyanov SD, Velev OD. 3D Printing by Multiphase Silicone/Water Capillary Inks. Adv Mater. 2017 Aug;29(30). doi: 10.1002/adma.201701554. Epub 2017 Jun 7. — View Citation

Saugstad OD, Aune D. Optimal oxygenation of extremely low birth weight infants: a meta-analysis and systematic review of the oxygen saturation target studies. Neonatology. 2014;105(1):55-63. doi: 10.1159/000356561. Epub 2013 Nov 15. — View Citation

Stenson BJ. Oxygen targets for preterm infants. Neonatology. 2013;103(4):341-5. doi: 10.1159/000349936. Epub 2013 May 31. — View Citation

Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update. Neonatology. 2019;115(4):432-450. doi: 10.1159/000499361. Epub 2019 Apr 11. — View Citation

Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL. European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. doi: 10.1159/000528914. Epub 2023 Feb 15. — View Citation

Xu JJ, Luo YJ, Wang JH, Xu WZ, Shi Z, Fu JZ, Shu Q. Patient-specific three-dimensional printed heart models benefit preoperative planning for complex congenital heart disease. World J Pediatr. 2019 Jun;15(3):246-254. doi: 10.1007/s12519-019-00228-4. Epub 2019 Feb 22. — View Citation

Zhao H, Lin G, Seong YH, Shi J, Xu J, Huang W. Anthropometric research of congenital auricular deformities for newborns. J Matern Fetal Neonatal Med. 2019 Apr;32(7):1176-1183. doi: 10.1080/14767058.2017.1402877. Epub 2017 Dec 8. — View Citation

Zheng J, He H, Kuang W, Yuan W. Presurgical nasoalveolar molding with 3D printing for a patient with unilateral cleft lip, alveolus, and palate. Am J Orthod Dentofacial Orthop. 2019 Sep;156(3):412-419. doi: 10.1016/j.ajodo.2018.04.031. — View Citation

* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time in which preterm maintain SatO2 below 85%.	To compare the time in which preterm maintain SatO2 below 85%.in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM).	7 days
Secondary	Time in which preterm maintain bradycardias.	To compare the time in which preterm maintain bradycardias - heart rate below 100 beats per minute - that occur in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM).	7 days
Secondary	Time in which preterm maintain SatO2 below 75%.	To compare the time in which preterm maintain SatO2 below 75%.in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM).	7 days
Secondary	Number of times requiring cardiopulmonary resuscitation	Compare the number of times requiring cardiorespiratory resuscitation with self-inflating bag in the context of apnea pause or severe desaturation in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM).	7 days
Secondary	Appearance of cutaneous lesions in nasal region or mucosa	To compare the appearance of cutaneous lesions in the nasal region or nasal mucosa as a consequence of the pressure exerted by any of the masks, indicating the location and degree of the wound in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM).	7 days
Secondary	Pain assessment with scoring scale.	To compare the degrees of pain, measured in the neonatal pain scale PIPP-R (Premature Infant Pain Profile-Revised), obtained every 12 hours in the period of time that customized 3D printed nasal mask (3DM) is used versus traditional nasal mask (TM). Regarding the PIPP-R scale, the minimum score is 1 and the maximum is 21. Scores between 1-6 correspond to mild pain, 7-11 moderate pain, and 12-21 severe pain.	7 days