Transpyloric Versus Gastric Feeding in Bronchopulmonary Dysplasia

Recruiting now · Not applicable

Conditions studied: Bronchopulmonary Dysplasia, Gastroesophageal Reflux

In brief

The goal of this clinical trial is to learn if transpyloric tube feeding (feeding directly into the small intestine) versus gastric tube feeding tolerably and effectively reduces gastroesophageal reflux in infants born premature who have been diagnosed with bronchopulmonary dysplasia. The main questions this trial aims to answer are: Does transpyloric as compared to gastric tube feeding result in differences in the amount of experienced hypoxemia (low oxygen level in the blood) or serious adverse events? Does transpyloric as compared to gastric tube feeding reduce the frequency and severity of gastroesophageal reflux (GER) measured using 24 hour esophageal pH-multichannel intraluminal impedance (pH-MII) monitoring? Participants will: Undergo pre-trial 24 hour pH-MII monitoring to determine baseline severity of GER. Be randomly assigned to receive transpyloric or gastric tube feeding for 2 weeks. Undergo repeat pH-MII at the end of the 2 week trial to assess for change in GER. Undergo continuous pulse oximetry to record level of hypoxemia during the 2 week trial. Undergo saliva and airway (if supported by a breathing tube) fluid collection to measure biomarkers of GER. Be monitored clinically for possible adverse events.

Key facts

Study ID: NCT06534359
Run by: Children's Hospital of Philadelphia
People needed: 60
Starts: 2025-07-15
Expected to finish: 2027-06-30
Last updated by the study team: 2026-07-17

Who can join

Age: 0 and older, up to 1. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Birth <32 weeks' gestation
Current postmenstrual age of 36-65 weeks
Grade 2-3 bronchopulmonary dysplasia (BPD: treatment with positive airway pressure at 36 weeks' PMA) or grade 1 BPD (treatment with ≤2L/min flow nasal cannular at 36 weeks' PMA) with subsequent need for prolonged positive airway pressure and full enteral tube feedings
Treatment with positive airway pressure (high flow nasal cannula, non-invasive positive airway pressure, or invasive ventilation) at enrollment
(4) Full gastric tube feedings (≥100mL/kg/d) at the time of enrollment (5) Parental consent to participate
Note: At least 20 infants receiving invasive ventilation will be enrolled to enable endotracheal biomarker testing.

You may not qualify if…

Transpyloric feedings received within 7d of enrollment
Use of a gastric acid suppression, GI promotility drug, or caffeine within 7d of enrollment
History of gastrostomy tube placement, gastric fundoplication, or bowel resection resulting in short gut with contraindication to transpyloric feeding
Plan to wean off positive airway pressure (for non-intubated subjects) or to be extubated to non-invasive support (for subjects receiving invasive ventilation) within the 2wk trial
Known intolerance to transpyloric feeding
Persistent >20% endotracheal tube leak (for intubated subjects only)
Active treatment with an investigational therapy as part of another interventional trial
severe congenital or genetic abnormality that adversely affects GI or cardiopulmonary function

Where it is running

Stanford University — Palo Alto, California, United States (enrolling)
Children's Hospital Colorado — Denver, Colorado, United States (enrolling)
Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States (enrolling)
Children's Mercy Hospital — Kansas City, Missouri, United States

Full record on ClinicalTrials.gov

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