Randomized study of nasal continuous positive airway pressure in the preterm infant with respiratory distress syndrome.
OBJECTIVE
To evaluate whether very preterm babies can be extubated successfully to nasal continuous positive airway pressure (nCPAP) within one hour of birth after receiving one dose of surfactant in the treatment of respiratory distress syndrome (RDS).


METHODS
Forty-two infants of 25 to 28(+6) wk of gestation were intubated at birth and given one dose of surfactant. They were then randomized within one hour of birth to either continue with conventional ventilation or to be extubated to nCPAP.


RESULTS
Eight out of 21 (38%) babies randomized to nCPAP did not require subsequent reventilation. (Ventilation rates of 62% vs 100%, p = 0.0034). The smallest baby successfully extubated weighed 745 g. There were also significantly fewer infants intubated in the nCPAP group at 72 h of age (47% vs 81%, p = 0.025). There was no significant difference between the two groups in the number of babies that died, developed chronic lung disease or severe intraventricular haemorrhage.


CONCLUSIONS
A significant number of very preterm babies with RDS can be extubated to nCPAP after receiving one dose of surfactant. nCPAP is a potentially useful modality of respiratory support even in very premature infants.
Tooley
J
J
Department of Paediatrics, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK. James.Tooley@bristol.ac.uk
Dyke
M
M
D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome