FIRST-ABC Pilot Study

FIRST-line support for Assistance in Breathing in Children Pilot Study

Status: Published

What is this study about?

Breathing support is the most common treatment given to sick children in a paediatric intensive care unit (PICU). There are two kinds of breathing support: invasive (via a tube into the wind pipe); and non-invasive (via a mask or hood over the face). Both methods are routinely used. However, there are concerns of increased risk of infection and lung damage associated with invasive breathing support and this has prompted greater use of non-invasive breathing support.

The traditional method of delivering non-invasive breathing support is through continuous positive airway pressure (CPAP). It is effective but often poorly tolerated by children. A newer method, high flow nasal cannula (HFNC), has rapidly become popular due to its ease of use and increased tolerance. However, this method is much more expensive. Therefore, a clinical trial is needed to compare these two different methods.

This pilot study tested whether it was possible to conduct the large-scale trial. We included 121 children requiring non-invasive breathing support admitted to PICUs in three NHS hospitals, half were randomly allocated to CPAP and the other other to HFNC.

When is it taking place?

The study started in December 2015 and completed recruitment in October 2016.

Who is leading the study?

Dr Padmanabhan Ramnarayan, Great Ormond Street Hospital for Children NHS Foundation Trust, London

This study was funded by the Great Ormond Street Hospital Children’s Charity (Project: 14HC30)

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