title: Does the use of primary continuous positive airway pressure reduce the need for intubation and mechanical ventilation in infants ≤32 weeks' gestation?
abstract: BACKGROUND
  Ventilator-induced lung injury is a recognized risk factor for bronchopulmonary dysplasia.
  
  
  OBJECTIVE
  To determine whether primary continuous positive airway pressure (CPAP), defined as CPAP without previous endotracheal intubation for any indication, can reduce the need for intubation and mechanical ventilation in infants born at ≤32 weeks' gestational age.
  
  
  METHODS
  The literature was reviewed using the methodology for systematic reviews for the Consensus on Resuscitation Science adapted from the American Heart Association's International Liaison Committee on Resuscitation.
  
  
  RESULTS
  Fourteen studies were reviewed. Eleven studies provided varying degrees of supportive evidence (level of evidence 3 to 4) that the use of primary CPAP can reduce the need for intubation and mechanical ventilation.
  
  
  CONCLUSIONS
  The use of CPAP as a primary intervention and mode of respiratory support is an option for infants ≤32 weeks' gestation, but avoidance of intubation and mechanical ventilation is more likely in mature infants >27 weeks' gestation.
authors.affiliation: Department of Paediatrics, University of Calgary; ; Alberta Health Services, Calgary, Alberta.
authors.forename: Wendy H
authors.initials: WH
authors.lastname: Yee
authors.forename: Jeanne
authors.initials: J
authors.lastname: Scotland
authors.forename: Yung
authors.initials: Y
authors.lastname: Pham
authors.forename: Robert
authors.initials: R
authors.lastname: Finch