Randomized, controlled trial of nasopharyngeal continuous positive airway pressure in the extubation of very low birth weight infants☆,☆☆,★,★★
Section snippets
METHODS
We sought to investigate the hypothesis under the conditions usually encountered in intensive care nurseries (management trial design). For this reason the study design allowed for a defined degree of clinical decision making by the patient care team. Clinical examinations that are not widely available in level 3 nurseries, such as preextubation pulmonary function testing, were not used.
All inborn and transferred infants admitted to the neonatal intensive care unit at the Medical University of
RESULTS
From Aug. 2, 1990, through Aug. 3, 1992, a total of 216 potentially eligible infants were admitted to the neonatal intensive care unit. Of these, 126 were enrolled in our study and randomly assigned to a treatment group. The remaining 90 infants born during the study period were not enrolled for the following reasons: presence of congenital anomalies, 4; inability to obtain consent or consent refused, 18; infant death before eligibility, 31 (including 2 infants for whom a decision not to
DISCUSSION
Beneficial effects of CPAP on the clinical courses of patients with respiratory diseases and its effects on obstructive and mixed apnea are well known.1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 15, 16 These clinical observations, supported by measurable effects on pulmonary function and mechanics that indicate the prevention of atelectasis, recruitment of small airways, increased airway diameter, and improved reflex-mediated respiratory responses,6, 7, 11, 15, 17 suggest a therapeutic role in the support
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Cited by (48)
Noninvasive Ventilation in the Age of Surfactant Administration
2019, Clinics in PerinatologyCitation Excerpt :Davis and Ho25 conducted a systematic review comparing the use of nasal CPAP with headbox oxygen in preterm infants being extubated following a period of intermittent positive pressure ventilation (IPPV). Davis and Ho identified 9 trials26–34 (Table 2). Most of the studies identified were conducted in the 1990s.
Noninvasive Ventilation of Preterm Infants
2018, The Newborn Lung: Neonatology Questions and Controversies, Third EditionA randomized controlled trial to compare heated humidified high-flow nasal cannulae with nasal continuous positive airway pressure postextubation in premature infants
2013, Journal of PediatricsCitation Excerpt :We calculate that a sample size of 300 is required to show an improvement in failure rate from 34% to 17%. Predefined failure criteria were used for the primary outcome in order to minimize bias, which is consistent with previous studies.18-21 The number of apneas and maximal sustained oxygen requirement were recorded from the daily bedside nursing chart.
Noninvasive Respiratory Support: An Alternative to Mechanical Ventilation in Preterm Infants. An Alternative to Mechanical Ventilation in Preterm Infants.
2012, The Newborn Lung: Neonatology Questions and Controversies Expert ConsultNoninvasive Respiratory Support
2011, Assisted Ventilation of the Neonate
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From the Department of Pediatrics, Medical University of South Carolina, Charleston
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Supported in part by the South Carolina American Lung Association.
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Reprint requests: David J. Annibale, MD, Department of Pediatrics, Medical University of South Carolina, 171 Ashley Ave., Charleston, SC 29425.
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