Early variable-flow nasal continuous positive airway pressure in infants < or =1000 grams at birth

J Perinatol. 2006 Mar;26(3):189-96. doi: 10.1038/sj.jp.7211454.

Abstract

Objective: To compare the incidence of chronic lung disease (CLD) in extremely low birth weight (ELBW, < or =1000 g) infants before and after the introduction of early, preferential application of nasal continuous airway pressure (NCPAP) utilizing a variable flow delivery system.

Study design: A retrospective cohort study of ELBW infants 2 years prior to (Pre-early NCPAP, n=96) and 2 years following (Early NCPAP, n=75) the initiation of an early NCPAP policy.

Results: There were no significant changes (Pre-early NCPAP vs Early NCPAP) in the incidences of CLD (35 vs 33%, P=0.81) or CLD or death (50 vs 43%, P=0.34). Infants in the Early NCPAP group weaned off mechanical ventilation and supplemental oxygen more rapidly than infants in the Pre-early NCPAP group (hazard ratio (HR) 1.80, P=0.002 and HR 1.69, P=0.01).

Conclusion: A policy of early NCPAP has not decreased the incidence of CLD despite a decrease in time to successful tracheal extubation.

MeSH terms

  • Bronchopulmonary Dysplasia / prevention & control*
  • Cohort Studies
  • Confidence Intervals
  • Continuous Positive Airway Pressure / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal
  • Male
  • Odds Ratio
  • Probability
  • Respiratory Distress Syndrome, Newborn / diagnosis
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome