Evidence map›Paper›PMID 40525736›Full record

Trial reportPediatric pulmonology2025

Late Permissive Hypercapnia for Mechanically Ventilated Preterm Infants: A Randomized Trial.

Colm P Travers, Samuel J Gentle, Vivek V Shukla, Inmaculada Aban, Aaron J Yee, Kimberly M Armstead, Rachel L Benz, Deborah Laney, Namasivayam Ambalavanan, Waldemar A Carlo

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric pulmonology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02799875 (A Randomized Controlled Trial of pH-Controlled Late Permissive Hypercapnia for Intubated and Ventilated Preterm Infants), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

NCT02799875 nacompletednot on this map

A Randomized Controlled Trial of pH-Controlled Late Permissive Hypercapnia for Intubated and Ventilated Preterm Infants

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2015 to 2021Enrolled130ConditionsPremature NeonateArmsHigher permissive hypercapnia, Lower Permissive Hypercapnia
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Association of Arterial PaCODiagnostics (Basel, Switzerland) · 2026
    Article
  3. 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

10 authors.

Colm P TraversDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0002-3218-1024
Samuel J GentleDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0003-0238-6472
Vivek V ShuklaDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Inmaculada AbanDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Aaron J YeeDepartment of Pediatrics, Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
Kimberly M ArmsteadDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Rachel L BenzDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Deborah LaneyDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Namasivayam AmbalavananDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0003-0731-9092
Waldemar A CarloDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Funding

Non-invasive oscillometry to measure lung mechanics, response to treatments, and predict longer-term pulmonary outcomes among preterm infants: a prospective cohort studyK23HL157618 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Colm Peter Travers · 2022 to 2026
$862k
NHLBI NIH HHS K23 HL157618This study was supported by grants from the National Institute of Health (Travers CP: K23HL157618).
6 · The paper itself

Abstract

objectiveTo determine if targeting higher levels of pH-controlled permissive hypercapnia beyond postnatal day 7-14 reduces mechanical ventilation duration in preterm infants.

methodsSingle-center randomized clinical trial with a 1:1 parallel allocation including infants from 22-36 weeks' gestation mechanically ventilated for respiratory distress syndrome on postnatal day 7-14. We targeted higher levels of pH-controlled permissive hypercapnia (60-75 mmHg and pH ≥ 7.20) or lower levels of pH-controlled permissive hypercapnia (40-55 mmHg and pH ≥ 7.25) for 28 days after randomization. The primary outcome was the number of days alive and ventilator-free in the 28 days after randomization.

resultsWe enrolled 130 infants with a gestational age (mean ± SD) of 24 weeks and 5 days ± 2 weeks and 0 days and birth weight of 657 ± 198 grams from December 2015 to May 2021. Infants randomized to higher levels of pH-controlled permissive hypercapnia had more alive ventilator-free days than infants randomized to lower levels of pH-controlled permissive hypercapnia (11 ± 10 vs. 6 ± 8; p = 0.009). Grade 2-3 bronchopulmonary dysplasia or death before discharge was not significantly lower in the higher carbon dioxide (PCO

conclusionsTargeting higher levels of permissive hypercapnia from postnatal day 7-14 increased the number of days alive and ventilator-free and may be lung protective compared with targeting lower levels.

trial registrationClinicaltrials.gov (identifier number NCT02799875). The first infant was enrolled in December 2015 and the trial was not registered until June 2016. The authors confirm that there were no changes made to the Institutional Review Board (IRB) approved trial protocol (dated 10/20/2015) or any amendments made after recruitment started, between the date of first enrollment and the date of clinicaltrials.gov registration, or between study commencement and completion. Furthermore, the authors confirm that the data were not unblinded until after the last infant had been enrolled (March 2021) and discharged from the hospital (August 2021). Study Details | Late Permissive Hypercapnia for Intubated and Ventilated Preterm Infants | ClinicalTrials.gov.

Indexed as

HypercapniaRespiration, ArtificialRespiratory Distress Syndrome, NewbornFemaleGestational AgeHumansHydrogen-Ion ConcentrationInfant, NewbornInfant, PrematureMaleartificialbronchopulmonary dysplasiahypercapniainfantnewbornprematurerespirationrespiratory distress syndrome

Identifiers

PMID40525736
PMCPMC12172392

What OpenQuestion holds

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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.