Aims: To assess the use of continuous positive airways pressure (CPAP) in Irish special and intensive care nurseries.
Methods: A one-page questionnaire on the use of CPAP was sent to a Consultant Neonatologist/ Paediatrician and a senior neonatal nurse at each of the 28 delivery units in the Republic and Northern Ireland. We asked for what clinical indications and in what patient groups CPAP was used; which pressure generating devices and nasal interfaces were used; and what pressures were used (cmH0). We also asked about the use of NIMV/NIPPV/ BiPAP. Finally a question was asked about each units practice when discontinuing CPAP.
Results: Replies were received from doctors and nurses at all units (56/56, 100%). Nasal CPAP was used at 24/28 units. CPAP is used as an aid to extubation in all units who ventilate infants (24/24, 100%). The Infant Flow Driver (Viays Healthcare, Yorba Linda CA, USA) is the most commonly used pressure-generating device used in 22/24 (92%) units, SiPAP 14/24 (58%) and Bubble CPAP in 5/24 (21%). All units use short binasal prongs with over half of units also using nasal mask interfaces. Infants at 16/24 units receive NIMV, with a starting rate that varies (mean 25bpm, range 10-50bpm). All but 3 units give trial periods off CPAP before stopping treatment.
CONCLUSIONS: CPAP is widely used to support extremely preterm infants with RDS. When NIMV is used there appears to be a wide variation in the inflation rates and peak inflating pressures (PIP) that are used.