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

Autor: Eze N; Division of Neonatology, Harbor-UCLA Medical Center, Torrance, CA, USA.; Children's Hospital of Orange County, Orange, CA, USA., Murphy D; Division of Neonatology, Harbor-UCLA Medical Center, Torrance, CA, USA.; Children's Hospital of Orange County, Orange, CA, USA., Dhar V; Children's Hospital of Orange County, Orange, CA, USA., Rehan VK; Division of Neonatology, Harbor-UCLA Medical Center, Torrance, CA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2018 Feb; Vol. 38 (2), pp. 164-168. Date of Electronic Publication: 2017 Oct 26.
DOI: 10.1038/jp.2017.161
Abstrakt: Objective: Though nasal continuous positive airway pressure (NCPAP) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning NCPAP is not established. In this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off NCPAP increases successful weaning from NCPAP in infants born <31 weeks gestational age.
Study Design: Infants were randomized to one of the two NCPAP weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off CPAP, protocol vs a non-sprinting (weaning pressure down) protocol.
Result: Eighty-six infants were enrolled in one of the two study groups. Thirty-one infants (77%) in the sprinting group and 30 (75%) in the non-sprinting group were successfully weaned off NCPAP at the first attempt (P>0.05). It took 1.3 (1 to 1.75) (median (IQR)) attempts and 7 (7 to 7) days to wean NCPAP off in the sprinting group vs 1.3 (1 to 1.75) attempts and 7 (7 to 10) days in the non-sprinting group (P>0.05). Additionally, no differences in the secondary outcomes of bronchopulmonary dysplasia, severe retinopathy of prematurity (⩾stage 3), periventricular leukomalacia and length of stay were noted between the two groups.
Conclusion: Weaning NCPAP via sprinting or non-sprinting protocol is comparable, not only for successful weaning but also for the occurrence of common neonatal morbidities that impact the long-term outcome in premature infants (ClinicalTrials.gov number, NCT02819050).
Databáze: MEDLINE
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