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

P Jegatheesan1, R L Keller, S Hawgood

  • 1Department of Pediatrics, University of California San Francisco, CA 94143-0748, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 3, 2006
PubMed

Insights

Early nasal continuous airway pressure (NCPAP) did not reduce chronic lung disease (CLD) in extremely low birth weight (ELBW) infants. However, infants receiving early NCPAP weaned off ventilation and oxygen faster.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Extremely low birth weight (ELBW) infants (< or =1000 g) are at high risk for chronic lung disease (CLD).
  • Nasal continuous airway pressure (NCPAP) is a common respiratory support method for neonates.
  • The impact of early, preferential NCPAP on CLD incidence in ELBW infants requires evaluation.

Purpose of the Study:

  • To compare the incidence of CLD in ELBW infants before and after implementing an early NCPAP policy.
  • To assess the effect of early NCPAP on respiratory support duration and outcomes.

Main Methods:

  • Retrospective cohort study design.
  • Compared ELBW infants (n=96) 2 years prior to early NCPAP policy with those (n=75) 2 years after.
  • Utilized a variable flow delivery system for NCPAP.

Main Results:

  • No significant difference in CLD incidence between groups (35% vs 33%, P=0.81).
  • No significant difference in CLD or death rates (50% vs 43%, P=0.34).
  • Early NCPAP group showed faster weaning from mechanical ventilation (HR 1.80, P=0.002) and supplemental oxygen (HR 1.69, P=0.01).

Conclusions:

  • An early NCPAP policy did not decrease the incidence of CLD in ELBW infants.
  • Early NCPAP facilitated quicker tracheal extubation and reduced time on supplemental oxygen.
  • Further strategies may be needed to prevent CLD in this vulnerable population.
Abstract

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