Introduction of Infant Flow nasal continuous airway pressure as the standard of practice in Poland: the initial 2-year experience.
OBJECTIVE
The aim of this prospective study was to evaluate whether a change in the standard of newborn care for respiratory insufficiency by widely introducing more aggressive use of nasal continuous airway pressure (nCPAP) and including Infant Flow technology would result in satisfactory outcomes.


METHODS
Prospectively defined analysis.


METHODS
Fifty-seven secondary and tertiary care neonatal centers in Poland.


METHODS
Patients were 1,299 newborns.


METHODS
None.


RESULTS
We carried out a prospectively defined analysis of 1,299 newborns included in the program between August 1, 2003, and April 30, 2005. The inclusion criterion was the occurrence of symptoms of respiratory failure irrespective of its etiology. Respiratory support was provided with the use of the Infant Flow Advance Driver. The analysis was made on data from prospectively designed questionnaires completed following each infant's treatment. Infants were placed into categories based on clinical indication for use. The primary end point was avoiding tracheal intubation. A high rate of acceptance of the new practice was observed across the substantial demographic and clinical diversity of newborns. Tracheal intubation was avoided in 78% of infants treated electively with nCPAP. Of those being weaned from mechanical ventilation, 61.2% were successfully weaned. Related complications were low (1.4% pneumothorax, 12% nasal injuries).


CONCLUSIONS
The new method of nCPAP with Infant Flow was adopted as standard practice in Poland. We monitored its safety and effectiveness over a 2-yr period and found it to be safe and effective as implemented. Additional research is still needed to determine the optimum patient population, strategy for use, and devices.
Swietliński
Janusz
J
Department of Anesthesiology and IntensiveTherapy, The Children's Memorial Health Institute, Warsaw.
Bober
Klaudiusz
K
Gajewska
Elzbieta
E
Helwich
Ewa
E
Lauterbach
Ryszard
R
Manowska
Małgorzata
M
Maruszewski
Bohdan
B
Szczapa
Jerzy
J
Hubicki
Lech
L
D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011044:Poland; D011175:Positive-Pressure Respiration / Q000379:methods*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000628:therapy*; D016896:Treatment Outcome