Early Bubble CPAP and Outcomes in ELBW Preterm Infants

High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study

“…There were no statistically significant differences in ventilator-days, deaths, infections, IVH or LOS. There is debate whether early NCPAP decreases the risk of BPD in infants <30 weeks GA. [4][5][6][7][8] Our data did not show a difference in BPD rates between the NCPAP and HHFNC groups. Although there was a lower rate of BPD in infants who received HHFNC as first intention versus NCPAP, especially in the 26 to 29 6/7 week GA group, the numbers were small and the power inadequate.…”

“…2,3 Given this, there is now a concerted effort in many practices to avoid the use of prolonged invasive ventilatory support when treating acute respiratory distress in premature infants with early application of nasal continuous positive airway pressure (NCPAP) either immediately after birth or following a brief period of intubation, mechanical ventilation and dosing with surfactant. [4][5][6][7][8] An alternative to the use of NCPAP as a non-invasive modality to support respiratory distress in premature infants has been the recent introduction of humidified high flow nasal cannula (HHFNC) devices in many units. Although its use has been widely adopted, there have been only a few published abstracts describing its use in the neonatal population and no clinical trials using flows >2 l/min.…”

Nasal CPAP vs. mechanical ventilation in 28-32 weeks preterm infants with early surfactant administration

“…Estos resultados se unen a los de muchas otras series citadas en la literatura científica, en las que se ha encontrado que la CPAP disminuye la incidencia de displasia broncopulmonar (3,4,(6)(7)(8)18,19,21,24,32,33). En otros estudios no se han encontrado diferencias en la incidencia de la displasia broncopulmonar, pero en ninguno de ellos se empleó la misma intervención evaluada en el presente estudio.…”

“…En los últimos años se ha acumulado evidencia sobre cómo el apoyo respiratorio con presión positiva continua en la vía aérea (Continuous Positive Airway Pressure, CPAP), comparado con el uso de la respiración mecánica asistida convencional, es una alternativa eficaz, no invasiva y de bajo costo que, además, presenta cada vez menos complicaciones, por lo que su uso es cada vez más frecuente para reducir la displasia broncopulmonar, particularmente en países con recursos económicos limitados (2,3).…”

Comparison of sprinting vs non-sprinting to wean nasal continuous positive airway pressure off in very preterm infants

“…A growing body of observational studies [4][5][6][7][8], clinical trials [1,[9][10][11], and reviews [12][13][14][15] suggest a role for the use of early CPAP as a means to decrease the need for mechanical ventilation without increasing morbidity. However, the optimal method of weaning off NCPAP is not established.…”