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Updated: Nov 1, 2025

Laryngeal Mask Airway LMA Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway SGA
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Growth Rates of Infants Randomized to Continuous Positive Airway Pressure or Intubation After Extremely Preterm Birth

Ariel A Salas1, Waldemar A Carlo1, Barbara T Do2

  • 1Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.

The Journal of Pediatrics
|June 22, 2021
PubMed

Insights

Early continuous positive airway pressure (CPAP) did not improve in-hospital growth rates in extremely preterm (EPT) infants compared to early intubation. However, improved growth in the first month was linked to better cognitive outcomes later.

Area of Science:

  • Neonatal medicine
  • Pediatric critical care
  • Respiratory support

Background:

  • Extremely preterm (EPT) infants face significant growth challenges.
  • Early respiratory support strategies aim to improve outcomes but their impact on growth is debated.

Purpose of the Study:

  • To assess the effect of early continuous positive airway pressure (CPAP) versus early intubation on nutritional intake and in-hospital growth in EPT infants.

Main Methods:

  • Analysis of data from the SUPPORT trial, comparing EPT infants (24-27 weeks gestation) randomized to early CPAP or early intubation.
  • Growth rates from birth to 36 weeks postmenstrual age (PMA) and neurodevelopmental outcomes at 18-22 months corrected age were evaluated.

Main Results:

  • No significant differences in growth rates between birth and 36 weeks PMA were observed between the CPAP and intubation groups.
  • Total nutritional intake and in-hospital comorbidities were similar between groups.
  • Higher growth rates between days 21-28 were associated with a lower risk of cognitive scores below 85 at corrected age.

Conclusions:

  • Early CPAP does not enhance in-hospital growth rates in EPT infants compared to early intubation.
  • While CPAP did not improve growth, early postnatal growth velocity may influence later cognitive development.
Abstract

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