Early variable-flow nasal continuous positive airway pressure in infants < or =1000 grams at birth.
OBJECTIVE
To compare the incidence of chronic lung disease (CLD) in extremely low birth weight (ELBW, < or =1000 g) infants before and after the introduction of early, preferential application of nasal continuous airway pressure (NCPAP) utilizing a variable flow delivery system.


METHODS
A retrospective cohort study of ELBW infants 2 years prior to (Pre-early NCPAP, n=96) and 2 years following (Early NCPAP, n=75) the initiation of an early NCPAP policy.


RESULTS
There were no significant changes (Pre-early NCPAP vs Early NCPAP) in the incidences of CLD (35 vs 33%, P=0.81) or CLD or death (50 vs 43%, P=0.34). Infants in the Early NCPAP group weaned off mechanical ventilation and supplemental oxygen more rapidly than infants in the Pre-early NCPAP group (hazard ratio (HR) 1.80, P=0.002 and HR 1.69, P=0.01).


CONCLUSIONS
A policy of early NCPAP has not decreased the incidence of CLD despite a decrease in time to successful tracheal extubation.
Jegatheesan
P
P
Department of Pediatrics, University of California San Francisco, CA 94143-0748, USA.
Keller
R L
RL
Hawgood
S
S
D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D015331:Cohort Studies; D016001:Confidence Intervals; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D016017:Odds Ratio; D011336:Probability; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome