Respiratory function monitoring during DCC in preterm infants - V1.0
Research type
Research Study
Full title
Respiratory function monitoring to assess the effect of deferred umbilical cord clamping on the cardiorespiratory parameters in preterm infants less than 34 weeks of gestation – a single centre prospective study
IRAS ID
332230
Contact name
Theodore Dassios
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Delayed/ deferred cord clamping (DCC) is recommended by several national and international organisations in neonates born preterm or at term not needing immediate resuscitation, including the World Health Organization, the National Institute of Health and Care Excellence and the International Federation of Gynaecology and Obstetrics. Advantages of deferred cord clamping are well established in infants born at term which include greater levels of haemoglobin and increased iron stores in infancy due to increased blood flow through the placenta. In infants born preterm DCC is associated with a reduced need for blood transfusions, higher haemoglobin levels and shorter hospital stays compared with early cord clamping. In a randomised study, the incidence of significant (grade 3 and 4) intraventricular haemorrhage (bleeding in the brain) was decreased with the use of DCC in preterm neonates.
The higher haemoglobin levels and superior oxygenation with DCC make it likely that pulmonary vessels dilate earlier, this however has not been assessed. Respiratory physiological monitoring is currently being practised in the neonatal units during resuscitation and is a useful method to monitor how the lungs work by assessing oxygen saturation, end tidal CO2 (ETCO2) and other respiratory parameters. Measurement of end tidal CO2 (ETCO2) is an indicator of pulmonary vasodilation. We therefore plan to undertake a study to identify whether deferred cord clamping allows early detection of ETCO2 and thus pulmonary vasodilation in preterm infants by comparing the infants who had DCC to who did not.
REC name
North of Scotland Research Ethics Committee 2
REC reference
24/NS/0051
Date of REC Opinion
17 Oct 2024
REC opinion
Further Information Favourable Opinion