title: CeasIng Cpap At standarD criteriA (CICADA): predicting a successful outcome.
abstract: This is a retrospective analysis of a multicentre randomised controlled trial (RCT) where we concluded that CeasIng Cpap At standerD criteriA (CICADA) in premature babies (PBs) <30 weeks gestational age (GA) was the significantly better method of ceasing CPAP. To identify factors that may influence the number of attempts to cease CPAP, we reviewed the records of 50 PBs from the RCT who used the CICADA method. PBs were grouped according to number of attempts to cease CPAP (fast group ≤2 attempts and slow group >2 attempts to cease CPAP). There were 26 (fast group) and 24 (slow group) PBs included in the analysis. Results showed significant differences in mean GA (27.8 ± 0.3 vs 26.9 ± 0.3 [weeks ± SE], p = 0.03) and birth weight ([Bwt]; 1080 ± 48.8 vs 899 ± 45.8 [grams ± SE], p = 0.01) between groups. Significantly fewer PBs in the fast group had a patent ductus arteriosus (PDA) compared to the slow group (5/26 (19.2%) vs 13/24 (54.2 %), p = 0.02). Bwt was a significant negative predictor of CPAP duration (r = -0.497, p = 0.03) and CPAP ceasing attempts (r = -0.290, p = 0.04).
  
  
  CONCLUSIONS
  PBs with a higher GA and Bwt without a PDA ceased CPAP earlier using the CICADA method. Bwt was better than GA for predicting CPAP duration and attempts to cease CPAP.
  
  
  BACKGROUND
  Our previous studies showed that CeasIng Cpap At standarD criteriA (CICADA) significantly reduces CPAP time, oxygen requirements and caffeine use. Some PBs however using the CICADA method required >2 attempts to cease CPAP ('slow CICADA' group).
  
  
  BACKGROUND
  PBs in the 'fast CICADA' group (<3 attempts to cease CPAP) (a) have longer gestational age and higher birth weight, (b) shorter mechanical ventilation and (c) lower incidence of patent ductus arteriosus. Attempts to cease CPAP decreased by 0.5 times per 1 week increase in GA and 0.3 times per 100-g increase in birth weight for PBs <30 weeks gestation.
authors.affiliation: Australian National University Medical School, Hospital Rd, Garran, ACT, 2605, Australia. u5133285@anu.edu.au.
authors.forename: Yue
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Neonatology, Centenary Hospital, Garran, ACT, PO Box 11, Woden Canberra, 2606, Australia. Margaret.Broom@act.gov.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Broom
authors.affiliation: Centre for Newborn Care, Westmead Hospital, Westmead, NSW, Australia. audrey_wright@wsahs.nsw.gov.au.
authors.forename: Audrey
authors.initials: A
authors.lastname: Wright
authors.affiliation: Grantley Stable Neonatal Intensive Care Unit, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, 4006, Australia. Donna_Hovey@health.qld.gov.au.
authors.forename: Donna
authors.initials: D
authors.lastname: Hovey
authors.affiliation: Australian National University Medical School, Hospital Rd, Garran, ACT, 2605, Australia. Abdel-Latif.Mohamed@act.gov.au.|Department of Neonatology, Centenary Hospital, Garran, ACT, PO Box 11, Woden Canberra, 2606, Australia. Abdel-Latif.Mohamed@act.gov.au.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.affiliation: Australian National University Medical School, Hospital Rd, Garran, ACT, 2605, Australia. Bruce.Shadbolt@act.gov.au.|Centre for Advances in Epidemiology and IT, Canberra Hospital, Garran, ACT, Australia. Bruce.Shadbolt@act.gov.au.
authors.forename: Bruce
authors.initials: B
authors.lastname: Shadbolt
authors.affiliation: Australian National University Medical School, Hospital Rd, Garran, ACT, 2605, Australia. David.Todd@act.gov.au.|Department of Neonatology, Centenary Hospital, Garran, ACT, PO Box 11, Woden Canberra, 2606, Australia. David.Todd@act.gov.au.
authors.forename: David A
authors.initials: DA
authors.lastname: Todd
mesh_terms: D001724:Birth Weight; D045422:Continuous Positive Airway Pressure; D004374:Ductus Arteriosus, Patent / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods
keywords: CPAP; Ceasing CPAP; Chronic lung disease; Continuous positive airway pressure; Patent ductus arteriosus; Premature babies; Premature infant; Respiratory support; Weaning