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Not yet recruitingNCT07709988NEODIALECTUpdated Jul 17, 2026

Neonatal Diaphragmatic Activity-Linked Extubation Conditions and Timing

An observational study in Study of Predictors of Successful Extubation in Preterm Infants, Extubation Succeeded and Extubation Failure, sponsored by Centre Hospitalier Intercommunal Creteil. Not yet recruiting. Open to participants aged 0 Days to 3 Months. Per ClinicalTrials.gov, last updated 2026-07-17.

Sponsored by Centre Hospitalier Intercommunal Creteil · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
20
Ages
0 Days to 3 Months
Sex
All
01

Study summary

The objective of this study is to evaluate the role of diaphragmatic electrical activity monitoring (collected by esophageal probe) around extubation of preterm patients in order to consider its use as a standardized objective criterion to aid in the decision to extubate.

Read the detailed description

All parents of newborns meeting the inclusion criteria and without exclusion criteria will be approached for the study. If the parents do not object, the investigators will include patients once a collegial decision to extubate has been made after re-verification of the inclusion/exclusion criteria.

After patient inclusion, patient data collection by Servo-tracker will be set up, and ancillary data (treatments, Neo Comfort scale, respiratory rate, transcutaneous capnography, ventilation parameters, tidal volume) will be recorded at a given time every hour until the patient is extubated.

At the same time, the investigators will extract medical and administrative data from the patients' electronic records into a database that can only be accessed on a department computer, protected by a password.

After extubation, the patient is monitored for 7 days to assess the need for reintubation and collect data if the patient is reintubated. At the end of the 7 days or after reintubation, the patient's study follow-up is complete.

They may be included again if they are extubated again during the study period.

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Conditions studied

  • Study of Predictors of Successful Extubation in Preterm Infants
  • Extubation Succeeded
  • Extubation Failure
  • Preterm
  • Electric Diaphragmatic Activity (EAdi)
  • Neonatal Intensive Care Unit (NICU)

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Keywords

  • Extubation success
  • Preterm
  • extubation failure
  • observational study
  • Electric diaphragmatic activity (EAdi)
  • neonatal intensive care unit (NICU)
03

In context

Premature Birth

2,554 studies on the registry are indexed under Premature Birth; 498 are open to participants now.

This study's planned enrollment of 20 is below the median of 112 across 777 observational studies indexed under Premature Birth.

Browse Premature Birth studies →

Lead sponsor

Centre Hospitalier Intercommunal Creteil is the lead sponsor of 131 studies on the registry; 36 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
0 Days to 3 Months
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients admitted to the neonatal intensive care unit at the Creteil Intercommunal Hospital Center

Inclusion criteria

  • All newborns born at \<32 weeks of amenorrhea hospitalized in the neonatal intensive care unit at CHIC
  • Patient intubated and ventialted with an Edi tube in place
  • Patient eligible for scheduled extubation

Exclusion criteria

Exclusion Criteria:

  • Absence of Edi tube
  • Palliative care situation
  • Patient treated with curare
  • Patients with neuromuscular disorders
  • Accidental extubation
  • Parental refusal
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
20 participants (estimated)
Target follow-up
7 Days
Patient registry
Yes

Groups and cohorts

  • Patients of neonatal intensive care unit

    * All newborns born at \<32 weeks of amenorrhea hospitalized in the neonatal intensive care unit at CHIC * Patient intubated and ventialted with an Edi tube in place * Patient eligible for scheduled extubation

06

What researchers measure

Primary outcomes

  1. Extubation success

    Comparaison with patients who experience extubation failure. Focusing on clinical, therapeutic, and ventilatory data. In particular data extracted by the servo-tracker software (collected from the time the software is installed on the ventilator following the decision to extubate until the actual extubation): * Maximum, minimum, and average EDI over the period * Tidal volume: maximum, minimum, and average over the period * Inspiratory time: maximum, minimum, and average over the period * Total time between the decision to extubate and the actual extubation This data will be used to calculate: * Neuro-mechanical efficiency: Mean tidal volume / Mean EDI max * Variability of the EDI max signal: its standard deviation * Respiratory variability: standard deviation of tidal volume

    Time frame: 7 days

Secondary outcomes

  1. Time to reintubation

    Duration between extubation and reintubation

    Time frame: 7 days

  2. Reintubation rate

    Ratio of the number of patients who were reintubated to the total population

    Time frame: 7 days

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Parrilla-Gomez FJ, Roche-Campo F, Italiano S, Parrilla-Gomez A, Moran I, Mancebo J, Maraffi T. Time course of electrical activity of the diaphragm (EAdi) in the peri extubation period and its role as predictor of extubation failure in difficult to wean patients. Crit Care. 2024 Sep 17;28(1):308. doi: 10.1186/s13054-024-05092-x. PubMed 39289731 ↗
  • Scholten AWJ, van Leuteren RW, de Waal CG, Kraaijenga JV, de Jongh FH, van Kaam AH, Hutten GJ. Diaphragmatic electromyography in infants: an overview of possible clinical applications. Pediatr Res. 2024 Jan;95(1):52-58. doi: 10.1038/s41390-023-02800-1. Epub 2023 Sep 2. PubMed 37660179 ↗
  • Hermeto F, Bottino MN, Vaillancourt K, Sant'Anna GM. Implementation of a respiratory therapist-driven protocol for neonatal ventilation: impact on the premature population. Pediatrics. 2009 May;123(5):e907-16. doi: 10.1542/peds.2008-1647. Epub 2009 Apr 20. PubMed 19380428 ↗
  • Khodak I, Kahovec M, Romano V, Nielsen A, Day CL, Dylag AM. Reducing Failed Extubations in Preterm Infants Via Standardization and Real-Time Decision Support. Pediatrics. 2024 Sep 1;154(3):e2023062930. doi: 10.1542/peds.2023-062930. PubMed 39118595 ↗
  • Sant'Anna G, Shalish W. Weaning from mechanical ventilation and assessment of extubation readiness. Semin Perinatol. 2024 Mar;48(2):151890. doi: 10.1016/j.semperi.2024.151890. Epub 2024 Mar 23. PubMed 38553331 ↗
  • Shalish W, Keszler M, Davis PG, Sant'Anna GM. Decision to extubate extremely preterm infants: art, science or gamble? Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):105-112. doi: 10.1136/archdischild-2020-321282. Epub 2021 Feb 24. PubMed 33627331 ↗
  • Shalish W, Kanbar L, Kovacs L, Chawla S, Keszler M, Rao S, Panaitescu B, Laliberte A, Precup D, Brown K, Kearney RE, Sant'Anna GM. The Impact of Time Interval between Extubation and Reintubation on Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants. J Pediatr. 2019 Feb;205:70-76.e2. doi: 10.1016/j.jpeds.2018.09.062. Epub 2018 Nov 5. PubMed 30404739 ↗
  • Hoff Calegari L, Goyal M, Dutta S, Mukerji A. Predictors and Outcomes of Extubation Failure in Preterm Neonates: A Systematic Review. Pediatrics. 2025 Feb 1;155(2):e2024068677. doi: 10.1542/peds.2024-068677. PubMed 39814054 ↗
  • Choi YB, Lee J, Park J, Jun YH. Impact of Prolonged Mechanical Ventilation in Very Low Birth Weight Infants: Results From a National Cohort Study. J Pediatr. 2018 Mar;194:34-39.e3. doi: 10.1016/j.jpeds.2017.10.042. Epub 2017 Dec 1. PubMed 29198532 ↗
  • Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, Walsh MC, Vohr BR, Stoll BJ, Carlo WA, Van Meurs KP, Rysavy MA, Patel RM, Merhar SL, Sanchez PJ, Laptook AR, Hibbs AM, Cotten CM, D'Angio CT, Winter S, Fuller J, Das A; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018. JAMA. 2022 Jan 18;327(3):248-263. doi: 10.1001/jama.2021.23580. PubMed 35040888 ↗

Study documents

  • Study protocol · Jun 2, 2026
  • Informed consent form · Dec 11, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — The DPI will not be disclosed and will be retained for only two years after the results are published

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07709988
Lead sponsor
Centre Hospitalier Intercommunal Creteil
Responsible party
Xavier Durrmeyer, MD (Coordonnateur, Centre Hospitalier Intercommunal Creteil) — Principal investigator
First posted
Jul 17, 2026
Start date
Jul 1, 2026 (estimated)
Primary completion
Jan 4, 2027 (estimated)
Completion
Jan 30, 2027 (estimated)
Last update
Jul 17, 2026

Study contacts

Emeric EG Genet, Medical Doctor
Contact
emeric.genet@chicreteil.fr
+33652555454
Xavier XD Durrmeyer, MD, Phd
Contact
durrmeyer.xavier@chicreteil.fr
0157028470

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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