Treatment of immature baboons for 28 days with early nasal continuous positive airway pressure

Am J Respir Crit Care Med. 2004 May 1;169(9):1054-62. doi: 10.1164/rccm.200309-1276OC. Epub 2004 Feb 12.


Using the 125-day baboon model of long-term bronchopulmonary dysplasia, we hypothesized that early use of nasal continuous positive airway pressure (nCPAP), a noninvasive ventilatory method, combined with prophylactic surfactant therapy would permit continuation of alveolar and vascular development in the lung. Retrospective human studies have shown that infants treated with nCPAP spend less time on mechanical ventilation and thereby sustain less volutrauma. After delivery by cesarean section at 125 days (term, 185 days), the infants received two doses of surfactant (Curosurf) and daily caffeine citrate. Weaning from low-volume positive pressure ventilation to nCPAP was attempted at 24 hours of age. Serial physiological parameters were recorded. Lung histopathology and morphometric measurements of nCPAP animals were done after necropsy at 28 days and data were compared with 125- and 156-day gestational controls. Documented episodes of clinical sepsis and pneumonia at postmortem examination were absent. nCPAP lungs showed enlarged thin-walled air spaces with minimal fibroproliferation and scattered secondary crests. Internal surface area and surface-to-volume ratio dimensions were similar to those of 156-day gestational control lungs, the intrauterine developmental control. nCPAP is an effective noninvasive ventilatory technique that minimizes lung injury in baboons at risk of developing bronchopulmonary dysplasia.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Animals
  • Animals, Newborn
  • Biological Products / therapeutic use
  • Biopsy
  • Bronchoalveolar Lavage Fluid / chemistry
  • Bronchopulmonary Dysplasia / etiology
  • Bronchopulmonary Dysplasia / pathology
  • Bronchopulmonary Dysplasia / therapy*
  • Caffeine / therapeutic use
  • Cesarean Section
  • Citrates / therapeutic use
  • Combined Modality Therapy
  • Continuous Positive Airway Pressure / instrumentation
  • Continuous Positive Airway Pressure / methods*
  • Disease Models, Animal*
  • Drug Combinations
  • Feasibility Studies
  • Humans
  • Infant, Newborn
  • Intensive Care, Neonatal / methods
  • Lung / growth & development
  • Papio
  • Parenteral Nutrition, Total / methods
  • Phospholipids / therapeutic use
  • Pulmonary Gas Exchange
  • Risk Factors
  • Time Factors
  • Ventilator Weaning / methods


  • Biological Products
  • Citrates
  • Drug Combinations
  • Phospholipids
  • Caffeine
  • poractant alfa
  • caffeine citrate