title: Binasal Prong versus Nasal Mask for Applying CPAP to Preterm Infants: A Randomized Controlled Trial.
abstract: Nasal continuous positive airway pressure (NCPAP) is being widely used for the treatment of respiratory distress syndrome (RDS) in preterm infants. However, there are only a few studies which compare different interfaces of NCPAP delivery and their effects on respiratory outcomes.
  
  
  
  We aimed to determine whether NCPAP applied with binasal prongs compared to that with a nasal mask (NM) reduces the rate of moderate/severe bronchopulmonary dysplasia (BPD) in preterm infants.
  
  
  
  Infants between 26 and 32 weeks' gestation who suffered from RDS and were treated with NCPAP were assessed. Parallel randomization was performed to eligible infants to receive NCPAP either via binasal prongs or NM. Infants were intubated if they fulfilled the predefined failure criteria. Data were collected by using the intention-to-treat principle.
  
  
  
  One hundred and sixty infants were screened and 149 were randomized. Seventy-five infants in the binasal prong (NP) group and 74 in the NM group were analyzed. Mean gestational ages were 29.3 ± 1.6 vs. 29.1 ± 2.0 weeks (p = 0.55), and birth weights were 1,225 ± 257 vs. 1,282 ± 312 g (p = 0.22) in the NP and NM groups, respectively. The frequency of NCPAP failure within 24 h of life was higher in the NP than the NM group (8 vs. 0%; p = 0.09). The median duration of NCPAP was significantly higher in the NP group [median 4 (1-5) vs. 2 (1-3) h, p < 0.01]. The rate of moderate and severe BPD was significantly lower in the NM (n = 2, 2.7%) when compared with the NP group (n = 11, 14.6%; p < 0.01). The BPD/death rates were not different between the 2 groups (NM group: n = 18 or 24.3%; NP group: n = 19 or 25.3%; p = 0.51).
  
  
  
  The NM was successfully used for delivering NCPAP in preterm infants, and no NCPAP failure was observed within the first 24 h. These data show that applying NCPAP by NM yielded a shorter duration of NCPAP and statistically reduced the rates of moderate and severe BPD.
authors: Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
authors: Birgul
authors: B
authors: Say
authors: Hayriye Gozde
authors: HG
authors: Kanmaz Kutman
authors: Serife Suna
authors: SS
authors: Oguz
authors: Mehmet Yekta
authors: MY
authors: Oncel
authors: Sema
authors: S
authors: Arayici
authors: Fuat Emre
authors: FE
authors: Canpolat
authors: Nurdan
authors: N
authors: Uras
authors: Sevilay
authors: S
authors: Karahan
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000209:etiology; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D008397:Masks; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D014421:Turkey