Randomized, controlled trial of nasopharyngeal continuous positive airway pressure in the extubation of very low birth weight infants☆,☆☆,★,★★
Section snippets
METHODS
We sought to investigate the hypothesis under the conditions usually encountered in intensive care nurseries (management trial design). For this reason the study design allowed for a defined degree of clinical decision making by the patient care team. Clinical examinations that are not widely available in level 3 nurseries, such as preextubation pulmonary function testing, were not used.
All inborn and transferred infants admitted to the neonatal intensive care unit at the Medical University of
RESULTS
From Aug. 2, 1990, through Aug. 3, 1992, a total of 216 potentially eligible infants were admitted to the neonatal intensive care unit. Of these, 126 were enrolled in our study and randomly assigned to a treatment group. The remaining 90 infants born during the study period were not enrolled for the following reasons: presence of congenital anomalies, 4; inability to obtain consent or consent refused, 18; infant death before eligibility, 31 (including 2 infants for whom a decision not to
DISCUSSION
Beneficial effects of CPAP on the clinical courses of patients with respiratory diseases and its effects on obstructive and mixed apnea are well known.1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 15, 16 These clinical observations, supported by measurable effects on pulmonary function and mechanics that indicate the prevention of atelectasis, recruitment of small airways, increased airway diameter, and improved reflex-mediated respiratory responses,6, 7, 11, 15, 17 suggest a therapeutic role in the support
References (18)
- et al.
The early use of continuous positive airway pressure in the treatment of idiopathic respiratory distress syndrome
J PEDIATR
(1975) - et al.
Optimal levels of CPAP for tracheal extubation of newborn infants
J PEDIATR
(1976) - et al.
Randomized controlled trial of very early continuous distending pressure in the management of preterm infants
Early Hum Dev
(1987) - et al.
Apnea of prematurity
J PEDIATR
(1975) - et al.
The effect of a low continuous positive airway pressure on the reflex control of respiration in the preterm infant
J PEDIATR
(1977) - et al.
Treatment of the idiopathic respiratory distress syndrome with continuous positive airway pressure
N Engl J Med
(1971) - et al.
Consecutive study of early CPAP-application in hyaline membrane disease
Eur J Pediatr
(1979) - et al.
Effect of continuous positive airway pressure breathing on cardiovascular function in infants with respiratory distress syndrome
Acta Paediatr Scand
(1977) - et al.
Nasal continuous positive airway pressure
Biol Neonate
(1976)
Cited by (0)
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From the Department of Pediatrics, Medical University of South Carolina, Charleston
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Supported in part by the South Carolina American Lung Association.
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Reprint requests: David J. Annibale, MD, Department of Pediatrics, Medical University of South Carolina, 171 Ashley Ave., Charleston, SC 29425.
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0022-3476/94 $3.00 + 0 9/23/52209