Does nasal CPAP reduce bronchopulmonary dysplasia (BPD)?
Early nasal continuous positive airway pressure (nCPAP) or early surfactant therapy with early extubation onto nCPAP rather than continued mechanical ventilation has been adopted by many centres, particularly in Scandinavia, as part of the treatment of newborns with respiratory distress syndrome. It has been suggested that bronchopulmonary dysplasia is less of a problem in centres adopting such a policy. Results from randomized trials suggest prophylactic or early nCPAP may reduce bronchopulmonary dysplasia (BPD), but further studies are required to determine the relative contributions of an early lung recruitment policy, early surfactant administration and nCPAP in reducing BPD. In addition, the optimum method of generating and delivering CPAP needs to be determined.


CONCLUSIONS
The efficacy of nCPAP in improving long-term respiratory outcomes needs to be compared with the newer ventilator techniques with the optimum and timing of delivery of surfactant administration.
Patel
Ds
D
Division of Asthma, Allergy and Lung Biology, King's College, London, United Kingdom.
Greenough
A
A
D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D009666:Nose; D011247:Pregnancy; D011248:Pregnancy Complications; D013501:Surface-Active Agents / Q000008:administration & dosage*
D013501:Surface-Active Agents