Early treatment with nasal continuous positive airway pressure in very low‐birth‐weight infants

Kamper, J; Wulff, Karl; Larsen, Camilla Marie; Lindequist, S

doi:10.1111/j.1651-2227.1993.tb12637.x

Cited by 118 publications

(62 citation statements)

References 18 publications

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“…NCPAP is effective in preventing extubation failure in preterm infants and avoiding the need for mechanical ventilation. [9][10][11][12] However, its use has been limited in some infants by common complications of CPAP devices: nasal trauma, obstruction by secretions requiring frequent removal for suctioning, kinking of the nasopharyngeal prongs in the pharynx and overall perceived patient discomfort. 13,14 Vapotherm is an HFNC system that prevents dryness of the nasal mucosa by warming and humidifying inhaled gas.…”

Section: Discussionmentioning

confidence: 99%

Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol

2007

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Objective: Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are frequent complications of prematurity. To decrease ventilator-induced lung injury, we evaluated the safety, efficacy and neonatal outcomes of a heated humidified high-flow nasal cannula (HFNC) system and an early extubation protocol (EEP) designed for preterm infants 25 to 29 weeks' gestational age (GA). Result: Inclusion criteria were met by 49/57 infants in the control group and 65/75 infants in the HFNC group. The groups had similar demographics, perinatal conditions, birthweight, GA, timing and total doses of surfactant. There were no differences in rates of extubation failure, patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, laser eye surgery, sepsis, BPD at 28 days and 36 weeks and death. The groups did not differ in oxygen use, i.v. steroid days, or parenteral nutrition days. Days to reach full feeds were similar. Infants in the HFNC group were extubated from a higher ventilator rate (32.6±8.5 vs 28±7.5, P ¼ 0.003) and spent fewer days on the ventilator (11.4±12.8 vs 18.5±21, P ¼ 0.028). Rates of ventilatorassociated pneumonia were higher in the control group (P ¼ 0.018). Discharge weights were greater in the HFNC group (P ¼ 0.016) despite similar length of stay and GA at discharge. Conclusion:High-flow nasal cannula use appears safe and well-tolerated. Infants extubated to HFNC spent fewer days on the ventilator. Additional benefits may include a decreased rate of ventilator associated with pneumonia and improved growth.

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Section: Discussionmentioning

confidence: 99%

Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol

2007

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“…12,13 CPAP has been associated with decreased BPD in several clinical reports. [14][15][16] Multivariate regression analysis has shown intubation and mechanical ventilation of preterm infants to be the single most important predictor of subsequent BPD. 2 The controversy of early vs delayed CPAP continues as many of the trials favoring early CPAP were carried out in the larger infants prior to routine use of antenatal steroids and postnatal surfactant.…”

Section: Discussionmentioning

confidence: 99%

Early Bubble CPAP and Outcomes in ELBW Preterm Infants

et al. 2003

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“…Subsequent studies demonstrated that it contributes to a reduction in the need and dependence of oxygen and respiratory rate as well as the need for mechanical ventilation [1][2].…”

Section: Introductionmentioning

confidence: 99%

Nasal Bilevel Versus Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

Aguiar¹,

Macedo²,

Voutsen³

et al. 2015

J Clin Trials

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Objective: We designed a study with a primary objective of comparing the effectiveness of nasal continuous positive airway pressure (nCPAP) versus bi-level CPAP (BiPAP) as the primary mode of non-invasive ventilation in preterm newborns. The primary outcome was need for invasive ventilation in the first 120 hours of life. The secondary objective was to compare these two groups regarding duration of non-invasive ventilation, use of surfactant, incidence of pneumothorax, bronchopulmonary dysplasia (BPD), peri and intraventricular haemorrhage (PIVH), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), sepsis, length of hospitalisation and mortality.Methods: Prospective, multicentre clinical trial enrolling 220 neonates born at 27 to 32+6 weeks of gestation randomly assigned at birth for either CPAP or BiPAP. Results:One hundred and nine neonates received NCPAP and 111 BiPAP. Invasive ventilation was needed in 18.3% in the CPAP group and 14.4% in the BiPAP group. This difference was not statistically significant. However, when stratifying the groups regarding gestational age (GA), we found a tendency favouring BiPAP in subgroup of 30 to 32+6 weeks. There was no difference regarding the secondary outcomes, except for an increase in NEC in the CPAP group. Multivariate analysis demonstrated a significant association between absence of premature rupture of membranes and the need of invasive ventilation within the first 120 hours of life, independently on the assigned mode of non invasive ventilation. Conclusion:BiPAP and CPAP are both effective and safe as a primary mode of ventilation in preterms between 27 and 32+6 weeks without important complications. In a subgroup of 30 to 32+6 weeks of gestation a better outcome using BiPAP was observed.

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Early treatment with nasal continuous positive airway pressure in very low‐birth‐weight infants

Cited by 118 publications

References 18 publications

Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol

Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol

Early Bubble CPAP and Outcomes in ELBW Preterm Infants

Nasal Bilevel Versus Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial

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