title: Positive effects of early continuous positive airway pressure on pulmonary function in extremely premature infants: results of a subgroup analysis of the COIN trial.
abstract: OBJECTIVE
  Early continuous positive airway pressure (CPAP) may reduce lung injury in preterm infants.
  
  
  METHODS
  Spontaneously breathing preterm infants were randomised immediately after birth to nasal CPAP or intubation, surfactant treatment and mechanical ventilation. Pulmonary function tests approximately 8 weeks post-term determined tidal breathing parameters, respiratory mechanics and functional residual capacity (FRC).
  
  
  RESULTS
  Seventeen infants received CPAP and 22 mechanical ventilation. Infants with early CPAP had less mechanical ventilation (4 vs 7.5 days; p=0.004) and less total respiratory support (30 vs 47 days; p=0.017). Post-term the CPAP group had lower respiratory rate (41 vs 48/min; p=0.007), lower minute ventilation (223 vs 265 ml/min/kg; p=0.009), better respiratory compliance (0.99 vs 0.82 ml/cm H(2)O/kg; p=0.008) and improved elastic work of breathing (p=0.004). No differences in FRC were found.
  
  
  CONCLUSIONS
  Early CPAP is feasible, shortens the duration of respiratory support and results in improved lung mechanics and decreased work of breathing.
authors.affiliation: Clinic for Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany. christoph.roehr@charite.de
authors.forename: C C
authors.initials: CC
authors.lastname: Roehr
authors.forename: H
authors.initials: H
authors.lastname: Proquitté
authors.forename: H
authors.initials: H
authors.lastname: Hammer
authors.forename: R R
authors.initials: RR
authors.lastname: Wauer
authors.forename: C J
authors.initials: CJ
authors.lastname: Morley
authors.forename: G
authors.initials: G
authors.lastname: Schmalisch
mesh_terms: D001724:Birth Weight; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D055370:Lung Injury / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000379:methods; D015656:Respiratory Mechanics; D056152:Respiratory Rate; D013990:Tidal Volume
chemical_list: D011663:Pulmonary Surfactants