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Nasal continuous positive airways pressure (NCPAP) reduces duration of ventilation and extubation failure in preterm infants with respiratory distress.1 Although starting preterm infants on NCPAP without prior ventilation (ie, primary treatment of respiratory distress) is as effective a strategy as routine ventilation2 and surfactant,3 NCPAP is rarely used in this way in the UK (reportedly 2% of units).4 A systematic review of interfaces and pressure sources found binasal prongs to be more effective than a single prong.5 A superior pressure source was not identified, although a recent randomised trial found advantages with bubble NCPAP (Fisher & Paykel Healthcare, Auckland, New Zealand) compared to the Infant Flow Driver (Viasys, Warwick …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.