Document Detail

Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial.
MedLine Citation:
PMID:  19948523     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the clinical course, respiratory outcomes and markers of inflammation in preterm infants with moderate respiratory distress syndrome (RDS) assigned from birth to nasal continuous positive airway pressure (NCPAP) or bi-level NCPAP. METHODS: A total of 40 infants with a gestational age (GA) of 28-34 weeks (<35 weeks' GA), affected by moderate RDS, were considered eligible and were randomised to NCPAP (group A; n=20, CPAP level=6 cm H(2)O) or to bi-level NCPAP (group B; n=20, lower CPAP level=4.5 cm H(2)O, higher CPAP level=8 cm H(2)O), provided with variable flow devices. Inflammatory response was the primary outcome; serum cytokines were measured on days 1 and 7 of life. Length of ventilation, oxygen dependency, need for intubation and occurrence of air leaks were considered as secondary outcomes. RESULTS: Infants showed similar characteristics at birth (group A vs group B: GA 30.3+/-2 vs 30.2+/-2 weeks, birth weight 1429+/-545 vs 1411+/-560 g) and showed similar serum cytokine levels at all times. Group A underwent longer respiratory support (6.2+/-2 days vs 3.8+/-1 days, p=0.025), longer O(2) dependency (13.8+/-8 days vs 6.5+/-4 days, p=0.027) and was discharged later (GA at discharge 36.7+/-2.5 weeks vs 35.6+/-1.2 weeks, p=0.02). All infants survived. No bronchopulmonary dysplasia (BPD) or neurological disorders occurred. CONCLUSIONS: Bi-level NCPAP was associated with better respiratory outcomes versus NCPAP, and allowed earlier discharge, inducing the same changes in the cytokine levels. It was found to be well tolerated and safe in the study population.
Gianluca Lista; Francesca Castoldi; Paola Fontana; Irene Daniele; Francesco Cavigioli; Samantha Rossi; Diego Mancuso; Roberta Reali
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-11-29
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F85-9     Citation Subset:  AIM; IM    
NICU, Children's Hospital, Via Castelvetro, Milan, Italy.
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MeSH Terms
Blood Pressure / physiology
Continuous Positive Airway Pressure / methods*
Cytokines / metabolism
Heart Rate / physiology
Infant, Newborn
Infant, Premature
Length of Stay
Oxygen / blood
Respiratory Distress Syndrome, Newborn / physiopathology,  therapy*
Treatment Outcome
Reg. No./Substance:
0/Cytokines; 7782-44-7/Oxygen

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