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Published on: December 22, 2023
Initiating nasal continuous positive airway pressure in preterm neonates at 5 cm as against 7 cm did not decrease the
Srinivas Murki1, Prem Prakash Nathani1, Deepak Sharma1
1Department of Neonatology, Fernandez Hospital, Hyderabad, India.
Starting bubble nasal continuous positive airway pressure (nCPAP) at 7 cm water pressure did not reduce the need for mechanical ventilation in preterm infants with respiratory distress compared to 5 cm. Outcomes were similar between groups.
Area of Science:
- Neonatal respiratory support
- Pediatric critical care
Background:
- Bubble nasal continuous positive airway pressure (nCPAP) is a common respiratory support for preterm neonates.
- The optimal starting pressure for bubble nCPAP remains undetermined.
Purpose of the Study:
- To investigate if initiating bubble nCPAP at 7 cm water pressure, compared to 5 cm, reduces the need for mechanical ventilation in preterm neonates with respiratory distress.
Main Methods:
- A randomized trial involving preterm neonates (27-34 weeks gestation) with respiratory distress.
- Infants were assigned to receive either high (7 cm water) or standard (5 cm water) nCPAP.
- The primary outcome was the requirement for mechanical ventilation within the first week of life.
Main Results:
- No significant difference in the need for mechanical ventilation between the high and standard nCPAP groups (21.7% vs 21.8%).
- Secondary outcomes, including mortality, air leaks, surfactant use, and bronchopulmonary dysplasia, were also similar between groups.
- The relative risk for mechanical ventilation was 0.99 (95% CI: 0.56-1.77).
Conclusions:
- Initiating bubble nCPAP at 7 cm water pressure does not decrease the need for mechanical ventilation in preterm neonates with respiratory distress compared to 5 cm water pressure.
- Higher starting nCPAP pressure did not improve other respiratory outcomes or reduce mortality.
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