Inhaled Nitric Oxide (iNO) for Congenital Diaphragmatic Hernia (CDH) - The "NoNO Trial" - a Multi-center, De-implementation, Stepped-wedge, Cluster-randomized Trial Within an Established Collaborative

Study Purpose

The purpose of this study is to Determine if deimplementation of iNO in the post-natal resuscitation/stabilization phase affects the composite outcome of ECLS use and/or mortality, as well as ECLS use, mortality, and/or oxygenation in CDH newborns and to establish the cost-effectiveness of deimplementing iNO as a therapy in the postnatal resuscitation/stabilization phase of CDH management, which will be assessed as the incremental health system costs (savings) per prevented ECLS use and/or death.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 0 Months - 1 Month
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Postnatal, live born neonates with CDH.
a. Presence of associated or additional anomalies is acceptable for inclusion.
  • - Bochdalek hernia location (right or left) - Diagnosed prior to 1 month of life.
  • - Born within or transferred to (within 1 week of life) a CDHSG member center participating in the trial.

Exclusion Criteria:

  • - CDH diagnosis after 1 month of age.
  • - Morgagni diaphragmatic hernia (central / anterior-medial diaphragmatic defect location) - Transferred to a CDH Study Group (CDHSG) member center after 1 week of life.
- Patients without potential access to iNO

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT05213676
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 4
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

The University of Texas Health Science Center, Houston
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Matthew Harting, MD, MS, FACS
Principal Investigator Affiliation The University of Texas Health Science Center, Houston
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Not yet recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Congenital Diaphragmatic Hernia
Additional Details

In this multi-center study, centers will use iNO per their usual protocol, and centers will then crossover to iNO de-implementation (that is, at the time of crossover, centers will stop using iNO in the initial resuscitation period). A stepped-wedge crossover study design will be used, and the timing of crossover will be cluster randomized at the level of the center.

Arms & Interventions

Arms

Active Comparator: Inhaled Nitric Oxide (iNO) use

The center will use iNO per their usual protocol in the initial resuscitation period (defined as birth through stabilization and CDH repair). No center will alter any component of their standard clinical practice guideline or protocol governing CDH care.

Active Comparator: De-implementation of Inhaled Nitric Oxide (iNO) use

The center will stop using iNO in the initial resuscitation period (defined as birth through stabilization and CDH repair).

Interventions

Drug: - Inhaled Nitric Oxide (iNO) use

The center will use iNO per their usual protocol in the initial resuscitation period (defined as birth through stabilization and CDH repair). No center will alter any component of their standard clinical practice guideline or protocol governing CDH care.

Other: - De-implementation of Inhaled Nitric Oxide (iNO) use

The center will stop using iNO in the initial resuscitation period (defined as birth through stabilization and CDH repair).

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Houston, Texas

Status

Address

The University of Texas Health Science Center at Houston

Houston, Texas, 77030

Site Contact

Matthew Harting, MD, MS, FACS

Matthew.T.Harting@uth.tmc.edu

713-500-7398

For more information, please contact PHA at Research@PHAssociation.org and refer to the terms of service below.

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