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Ventilator Pressure and Optimization of Compliance and Hemodynamics

Ventilator Pressure and Optimization of Compliance and Hemodynamics: VPOCH Trial

Who can join

7 Days – 30 Days · All sexes

Inclusion Criteria:

Preterm infants with recovering respiratory distress syndrome (RDS) who were born at a gestational age \< 34 weeks and are receiving respiratory support via conventional mechanical ventilation or on HFJV.

* Post-natal age \> 7 days and less than 1 month (outside golden week protocol)
* Gestational age ≥ 21 weeks and ≤ 34 week
* Infants with written informed consent obtained from legal guardian

Exclusion Criteria:

* Blood culture-positive sepsis
* Congenital anomalies affecting respiration
* Cyanotic or ductal-dependent congenital heart disease
* Newborns who are considered too unstable for study enrolment per neonatology attending
* Newborns on pressors or steroids for maintaining cardiac output
* Non-invasive ventilation or newborn with significant BPD (bronchopulmonary dysplasia) with pulmonary hypertension (HTN)
* Open skin wounds or abrasions on the chest wall.

About the study

In preterm infants \< 34 weeks' gestation at birth receiving respiratory support with invasive positive pressure ventilation, the positive end-expiratory pressure (PEEP) of best compliance will increase the cardiac output and improve oxygenation. This study may emphasize using point-of-care echocardiography along with electrical impedance tomography (EIT) to optimize ventilator settings in preterm infants.

Infants will be randomized to a 4-hour crossover period of increasing and decreasing PEEP in random order from baseline to determine compliance, oxygenation, and cardiac hemodynamics at each step using echocardiography (ECHO) and EIT measurements. There will be a 15-minute washout period after changes prior to data collection.

What is being tested

• Increase in the PEEP followed by decrease in the PEEP (other)
• Decrease in the PEEP followed by increase in the PEEP (other)

Sponsor: University of Alabama at Birmingham · Participants: 24 · Started: Aug 1, 2026

Contact the study team

• Kulsajan S Bhatia, MD · Phone: 9172149882

Official record on ClinicalTrials.gov — NCT06512935

Locations in the U.S.

Conditions

• Bronchopulmonary Dysplasia
• Respiratory Distress Syndrome

From ClinicalTrials.gov, data retrieved Oct 2, 2026. Each study sets its own eligibility; the study team decides who can join.