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Effect on lung function of continuous positive airway pressure administered either by infant flow driver or a single
V Kavvadia1, A Greenough, G Dimitriou
1Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London, UK.
Insights
Continuous positive airway pressure (CPAP) via an infant flow driver (IFD) showed no short-term lung function benefits compared to a single nasal prong in preterm infants post-extubation. Both methods improved lung function, but IFD use was linked to hyperoxia.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Critical Care
Background:
- Preterm infants often require respiratory support after extubation.
- Continuous positive airway pressure (CPAP) is a common non-invasive ventilation method.
- Different CPAP delivery systems exist, with varying clinical efficacies.
Purpose of the Study:
- To compare the effectiveness of CPAP delivered by an infant flow driver (IFD) versus a single nasal prong in improving lung function in preterm infants post-extubation.
- To assess secondary outcomes such as oxygen requirements and respiratory system compliance.
Main Methods:
- A study involving 36 preterm infants (median gestational age 29 weeks) was conducted.
- Infants were divided into three groups: IFD CPAP, single nasal prong CPAP, and no CPAP.
- Lung function was evaluated by measuring supplementary oxygen needs and respiratory system compliance.
Main Results:
- Both CPAP groups showed improved lung function after 24 hours, reaching levels comparable to the non-CPAP group.
- A significant decrease in supplementary oxygen requirement was observed in the single nasal prong group.
- Four infants receiving IFD CPAP experienced hyperoxia, while none in the single nasal prong group did.
Conclusions:
- Infant flow driver (IFD) CPAP does not offer a short-term advantage over single nasal prong CPAP in preterm infants after extubation.
- Single nasal prong CPAP demonstrated a significant improvement in oxygenation.
- Potential for hyperoxia exists with IFD use, warranting careful monitoring.
Unlabelled:
The aim of this study was to assess if continuous positive airways pressure (CPAP) delivered by an infant flow driver (IFD) was a more effective method of improving lung function than delivering CPAP by a single nasal prong. A total of 36 infants (median gestational age 29 weeks, range 25-35 weeks) were studied, 12 who received CPAP via an IFD, 12 who received CPAP via a single nasal prong and 12 without CPAP. CPAP was administered post extubation if apnoeas and bradycardias or a respiratory acidosis developed or electively if the infant was of birth weight <1.0 kg. Lung function was assessed by the supplementary oxygen requirement and measurement of compliance of the respiratory system using an occlusion technique. Assessments were made immediately prior to and after 24 h of CPAP administration and at similar postnatal ages in the non-CPAP group. The infants who did not require CPAP had better lung function (non significant) than the other two groups before they received CPAP. After 24 h, lung function had improved in both CPAP groups to the level of the non CPAP infants. The supplementary oxygen requirements of all three groups decreased over the 24 h period, but this only reached significance in the single nasal prong group (P<0.05). Four infants supported by the IFD, but none with a single nasal prong, became hyperoxic.
Conclusion:
Continuous positive airways pressure administration via the infant flow driver appears to offer no short-term advantage over a single nasal prong system when used after extubation in preterm infants.