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High vs low CPAP strategy with aerosolized calfactant in preterm infants with respiratory distress syndrome

D C Kaluarachchi1, E Gerday2, T Bahr2

  • 1Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA. kaluarachchi@pediatrics.wisc.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 9, 2024
PubMed

Insights

High versus low continuous positive airway pressure (CPAP) strategies did not differ in preventing CPAP failure in infants receiving aerosolized calfactant. Further research is needed to confirm these findings.

Area of Science:

  • Neonatal respiratory support
  • Pulmonary surfactant therapy

Background:

  • Continuous positive airway pressure (CPAP) is a common respiratory support method for preterm infants.
  • The optimal CPAP strategy to prevent CPAP failure, defined as the need for endotracheal intubation, remains unclear.
  • Aerosolized calfactant is a potential therapeutic agent for respiratory distress syndrome.

Purpose of the Study:

  • To compare the risk of CPAP failure between high and low CPAP strategies in infants receiving aerosolized calfactant.
  • To analyze data from the AERO-02 clinical trial and AERO-03 expanded access program.

Main Methods:

  • Infants born between 29 0/7 and 36 6/7 weeks of gestation were included.
  • Infants were assigned to either a low CPAP group (4-7 cm H2O) or a high CPAP group (8-10 cm H2O).
  • CPAP failure and pneumothorax rates were compared between the groups.

Main Results:

  • There were no significant differences in CPAP failure or pneumothorax rates between the high and low CPAP groups.
  • The adjusted odds ratio for CPAP failure was 0.61 (95% CI: 0.29, 1.24), indicating no statistically significant difference.
  • Baseline characteristics did not significantly alter the observed outcomes.

Conclusions:

  • The study found no difference in CPAP failure rates when comparing high versus low CPAP strategies in infants receiving aerosolized calfactant.
  • The efficacy of a high CPAP strategy in conjunction with aerosolized surfactant treatment requires further investigation in future studies.
Abstract

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