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Continuous positive airway pressure in preterm neonates: an update of current evidence and implications for

Neeraj Gupta1, Shiv Sajan Saini, Srinivas Murki

  • 1Departments of Pediatrics, AIIMS Jodhpur; *PGIMER, Chandigarh; Fernandez Hospital Hyderabad and AIIMS, New Delhi, India. Correspondence to: Dr Praveen Kumar, Professor, Neonatal Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160 012, India. drpkumarpgi@gmail.com.

Indian Pediatrics
|May 2, 2015
PubMed

Insights

Continuous Positive Airway Pressure (CPAP) is an effective, minimally invasive respiratory support for newborns. Early and judicious CPAP use, especially in resource-limited settings, is recommended, with ongoing research into optimal delivery methods and interfaces.

Area of Science:

  • Neonatal Medicine
  • Respiratory Care
  • Public Health

Background:

  • Continuous Positive Airway Pressure (CPAP) offers a cost-effective, minimally invasive respiratory support method for newborns.
  • Its application and evidence base are crucial, particularly for developing countries.

Purpose of the Study:

  • To comprehensively review existing evidence on Continuous Positive Airway Pressure (CPAP) utilization in neonates.
  • To assess the applicability and effectiveness of CPAP in resource-limited settings.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, CENTRAL, Cochrane).
  • Keywords included CPAP, continuous positive airway pressure, non-invasive ventilation, and neonatal terms.
  • Reference lists of identified articles and reviews were also screened.

Main Results:

  • Early CPAP with rescue surfactant (InSurE) is optimal for respiratory distress syndrome in preterm infants.
  • Delivery room CPAP is feasible, reducing surfactant and mechanical ventilation needs by approximately 50%.
  • Heated humidified high-flow nasal cannula is effective for post-extubation support; optimal interfaces and delivery methods require further investigation.

Conclusions:

  • Early and judicious application of CPAP is an effective neonatal intervention.
  • Immediate scaling-up of CPAP is needed in resource-limited settings.
  • Future research should prioritize ideal CPAP interfaces and delivery techniques.
Abstract

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