Abstract
Unexpected stability in arterial oxygen (PO2) and carbon dioxide tensions (PCO2) has been noted in infants recovering from RDS upon the discontinuation of CPAP at 6cm H20. Twenty-seven infants (weight 880-2650gms, gestational age 29-36 weeks) were treated with prong CPAP at a mean age of 9.4 hours and for a mean duration of 63.7 hours. CPAP was discontinued when FIO2 requirement fell below .3 and stable PO2 was maintained for 4 hours. Abrupt cessation of CPAP at 6cm H2O resulted in a mean change in PO2 of -2torr and a mean change in PCO2 of -1 torr. 43% of PO2 values increased (mean, 10 torr) and 56% of PCO2 values decreased (mean, 6 torr). This response did not vary with birth weight, gestational age, severity of disease, or duration on CPAP.
We postulate that the mechanism for the stability of arterial blood gas tensions unresponsive to the removal of CPAP is due to opposing physiologic changes, decreased alveolar ventilation and increased alveolar perfusion.
We conclude that PO2 and PCO2 are not affected by the withdrawal of nasal CPAP at 6cm H2O and that time consuming weaning procedures are unnecessary.
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Hegui, T., Hiatt, M. 975 THE RESPONSE OF PO2 AND PCO2 TO THE WITHDRAWAL OF CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) IN INFANTS RECOVERING FROM RESPIRATORY DISTRESS SYNDROME. Pediatr Res 12 (Suppl 4), 526 (1978). https://doi.org/10.1203/00006450-197804001-00981
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DOI: https://doi.org/10.1203/00006450-197804001-00981