Abstract 1341 Poster Session II, Sunday, 5/2 (poster 43)

Introduction: Recurrent episodes of apnea is a frequent problem in premature infants. CPAP administered via nasal prongs has been found to be an effective mode of treatment.

Objectives: To compare the frequency of episodes of apnea, bradycardia and desaturations in very low birth weight infants utilizing two systems of nasal CPAP delivery.

Methods: Following parental consent, 16 premature infants, mean birth weight 902 g (580-1540 g), mean gestation 26.3 weeks (23-30 weeks) with frequent significant episodes of apnea, bradycardia and desaturations were prospectively randomized to a double cross-over trial utilizing a conventional system of CPAP delivery by nasal prongs: Infant Star 500 (Infrasonics Inc.) versus the Aladdin Infant Flow System (Hamilton Medical). With the Aladdin system, infant's flow demand during nasal CPAP therapy is provided by gas from two injector jets located in the nasal prongs. During exhalation, the patient is assisted by the "coanda effect," (a fluidic flip) which decreases expiratory resistance and work of breathing. A significant apnea was defined as cessation of air flow >20 seconds duration, a bradycardia as a fall in the baseline heart rate by 30%, and a desaturation as a fall in oxygen saturation below 88%. Three 6-hour periods utilizing alternate CPAP delivery systems were continuously recorded. The number of apnea, bradycardia and desaturations per hour of tracing was calculated and compared between both CPAP systems. CPAP was administered at 6 cmH2O

Results: There was no statistically significant difference in the number of episodes of apneas, bradycardias or desaturations per hour of tracing among the two nasal CPAP delivery systems.

Conclusion: We found no clear advantage with either system of nasal CPAP delivery over the other in the frequency of apnea, bradycardia and desaturation episodes in very low birth weight infants.