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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
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Published on: December 5, 2025

Prophylactic nasal continuous positive airways pressure for preventing morbidity and mortality in very preterm

P Subramaniam1, D J Henderson-Smart, P G Davis

  • 1Dept Paediatrics, Hospital Ipoh, Ipoh, Malaysia, 30990. premasivapalan@hotmail.com

The Cochrane Database of Systematic Reviews
|July 22, 2005
PubMed

Insights

Prophylactic nasal continuous positive airway pressure (CPAP) for very preterm infants does not show significant benefits and may increase risks. More research is needed to determine its effectiveness and safety.

Area of Science:

  • Neonatal Medicine
  • Respiratory Support
  • Clinical Trials

Background:

  • Previous cohort studies suggested early nasal CPAP benefits for preterm infants.
  • Nasal CPAP may reduce intubation and chronic lung disease (CLD).

Purpose of the Study:

  • To evaluate prophylactic nasal CPAP in very preterm infants.
  • To determine if early CPAP reduces intermittent positive pressure ventilation (IPPV) and CLD without adverse effects.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Included infants < 32 weeks gestation or < 1500g birth weight.
  • Compared prophylactic nasal CPAP with standard care.

Main Results:

  • No statistically significant differences in outcomes between groups.
  • Trends towards increased BPD, death, and IVH in the CPAP group in one trial.
  • Trends towards increased severe IVH in the CPAP group in another trial.

Conclusions:

  • Insufficient evidence to confirm the effectiveness of prophylactic nasal CPAP.
  • No demonstrated benefit in reducing IPPV use.
  • Potential for increased adverse outcomes warrants further investigation.
Abstract

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