Evidence map›Paper›PMID 28606907›Full record

Trial reportBMJ open2017

FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): protocol for a multicentre randomised feasibility trial of non-invasive respiratory support in critically ill children.

Padmanabhan Ramnarayan, Paula Lister, Troy Dominguez, Parviz Habibi, Naomi Edmonds, Ruth Canter, Paul Mouncey, Mark J Peters

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02612415 (FIRST-ABC Feasibility Study), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02612415 phase2 / phase3completednot on this map

FIRST-ABC Feasibility Study: Feasibility Study for a Randomised Trial of High Flow Nasal Cannula (HFNC) Versus Continuous Positive Airway Pressure (CPAP) for Non-invasive Respiratory Support in Critically Ill Children

TypeinterventionalSponsorGreat Ormond Street Hospital for Children NHS Foundation TrustRan2015 to 2016Enrolled121ConditionsHypoxia, Respiratory Acidosis, Moderate/Severe Respiratory DistressArmsTreatment strategy: Non-invasive respiratory support delivered via high flow nasal cannula, Treatment strategy: Non-invasive respiratory support delivered via continuous positive airway pressure
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. High flow nasal cannula for respiratory support in term infants.The Cochrane database of systematic reviews · 2023
    Pooled it
  2. Trial
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Padmanabhan RamnarayanChildren's Acute Transport Service, Critical Care Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Paula ListerPaediatric and Neonatal Intensive Care Unit, Critical Care Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Troy DominguezCardiac Intensive Care Unit, Critical Care Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Parviz HabibiPaediatric Intensive Care Unit, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Naomi EdmondsPaediatric Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, UK.
Ruth CanterClinical Trials Unit, Intensive Care National Audit and Research Centre (ICNARC), Napier House, High Holborn, London, UK.
Paul MounceyClinical Trials Unit, Intensive Care National Audit and Research Centre (ICNARC), Napier House, High Holborn, London, UK.
Mark J PetersPaediatric and Neonatal Intensive Care Unit, Critical Care Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust · GBIntensive Care National Audit & Research Centre · GBBarts Health NHS Trust · GBImperial College Healthcare NHS Trust · GBSt. Mary's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOver 18 000 children are admitted annually to UK paediatric intensive care units (PICUs), of whom nearly 75% receive respiratory support (invasive and/or non-invasive). Continuous positive airway pressure (CPAP) has traditionally been used to provide first-line non-invasive respiratory support (NRS) in PICUs; however, high-flow nasal cannula therapy (HFNC), a novel mode of NRS, has recently gained popularity despite the lack of high-quality trial evidence to support its effectiveness. This feasibility study aims to inform the design and conduct of a future definitive randomised clinical trial (RCT) comparing the two modes of respiratory support. METHODS AND ANALYSIS: We will conduct a three-centre randomised feasibility study over 12 months. Patients admitted to participating PICUs who satisfy eligibility criteria will be recruited to either group A (primary respiratory failure) or group B (postextubation). Consent will be obtained from parents/guardians prior to randomisation in 'planned' group B, and deferred in emergency situations (group A and 'rescue' group B). Participants will be randomised (1:1) to either CPAP or HFNC using sealed, opaque envelopes, from a computer-generated randomisation sequence with variable block sizes. The study protocol specifies algorithms for the initiation, maintenance and weaning of HFNC and CPAP. The primary outcomes are related to feasibility, including the number of eligible patients in each group, feasibility of randomising >50% of eligible patients and measures of adherence to the treatment protocols. Data will also be collected on patient outcomes (eg, mortality and length of PICU stay) to inform the selection of an appropriate outcome measure in a future RCT. We aim to recruit 120 patients to the study. ETHICS AND DISSEMINATION: Ethical approval was granted by the National Research Ethics Service Committee North East-Tyne&Wear South (15/NE/0296). Study findings will be disseminated through peer-reviewed journals, national and international conferences. TRIALS REGISTRATION NUMBER: NCT02612415; pre-results.

Indexed as

CannulaAdolescentAlgorithmsChildChild, PreschoolClinical ProtocolsContinuous Positive Airway PressureCritical IllnessFemaleHumansIntensive Care Units, PediatricMaleOxygenOxygen Inhalation TherapyRespiratory InsufficiencyTreatment OutcomeOxygencontinuous positive airway pressurehigh flow nasal cannula therapynon-invasive respiratory supportpaediatric critical care

Identifiers

PMID28606907
PMCPMC5541500
OpenAlexW2626566760

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.