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  • Original Article
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Early variable-flow nasal continuous positive airway pressure in infants ⩽1000 grams at birth

Journal of Perinatology volume 26, pages 189–196 (2006)Cite this article

Abstract

Objective:

To compare the incidence of chronic lung disease (CLD) in extremely low birth weight (ELBW, ⩽1000 g) infants before and after the introduction of early, preferential application of nasal continuous airway pressure (NCPAP) utilizing a variable flow delivery system.

Study design:

A retrospective cohort study of ELBW infants 2 years prior to (Pre-early NCPAP, n=96) and 2 years following (Early NCPAP, n=75) the initiation of an early NCPAP policy.

Results:

There were no significant changes (Pre-early NCPAP vs Early NCPAP) in the incidences of CLD (35 vs 33%, P=0.81) or CLD or death (50 vs 43%, P=0.34). Infants in the Early NCPAP group weaned off mechanical ventilation and supplemental oxygen more rapidly than infants in the Pre-early NCPAP group (hazard ratio (HR) 1.80, P=0.002 and HR 1.69, P=0.01).

Conclusion:

A policy of early NCPAP has not decreased the incidence of CLD despite a decrease in time to successful tracheal extubation.

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Abbreviations

BW:

birth weight

CLD:

chronic lung disease

DR:

delivery room

ELBW:

extremely low birth weight

FiO2:

fraction of inspired oxygen

GA:

gestational age

ICH:

intracranial hemorrhage

NCPAP:

nasal continuous positive airway pressure

NEC:

necrotizing enterocolitis

O2:

oxygen

PDA:

patent ductus arteriosus

PMA:

post-menstrual age

RDS:

respiratory distress syndrome

SIMV:

synchronized intermittent mandatory ventilation

SpO2:

oxygen saturation measured by pulse oximety

V T :

tidal volume.

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Acknowledgements

We gratefully acknowledge the staff of the Neonatal Clinical Physiology Laboratory for their careful data collection.

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Authors and Affiliations

  1. Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA

    P Jegatheesan, R L Keller & S Hawgood

  2. Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA

    S Hawgood

Authors
  1. P Jegatheesan
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  2. R L Keller
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  3. S Hawgood
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Correspondence to R L Keller.

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Jegatheesan, P., Keller, R. & Hawgood, S. Early variable-flow nasal continuous positive airway pressure in infants ⩽1000 grams at birth. J Perinatol 26, 189–196 (2006). https://doi.org/10.1038/sj.jp.7211454

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