CPAP via single or dual nasal prongs

Managing successful extubation of ventilated premature infants is more art than science and is fraught with difficulty, so that any study which purports to assist in this difficult process is bound to be read with interest. Davis and colleagues (page 82) describe the results of a randomised controlled trial of the use of double versus single nasal prongs after extubation. Significantly fewer babies (24% versus 37%) “failed” extubation. However, the criteria for failure was not reventilation, but included apnoea; an increase of more than 15% in the inspired oxygen concentration; and respiratory acidosis. The failure rate of single prong extubation was thus much higher than in …