Document Detail

A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome.
MedLine Citation:
PMID:  19230906     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the efficacy and safety of bubble continuous positive airway pressure (CPAP) and Infant Flow Driver (IFD) CPAP for the post-extubation management of preterm infants with respiratory distress syndrome (RDS). STUDY DESIGN: A total of 140 preterm infants at 24 to 29 weeks' gestation or with a birth weight of 600 to 1500 g who were ventilated at birth for RDS were randomized to receive either IFD CPAP (a variable-flow device) or bubble CPAP (a continuous-flow device). A standardized protocol was used for extubation and CPAP. No crossover was allowed. The primary outcome was successful extubation maintained for at least 72 hours. Secondary outcomes included successful extubation maintained for 7 days, total duration of CPAP support, chronic lung disease, and complications of prematurity. RESULTS: Seventy-one infants were randomized to bubble CPAP, and 69 were randomized to IFD CPAP. Mean gestational age and birth weight were similar in the 2 groups, as were the proportions of infants who achieved successful extubation for 72 hours and for 7 days. However, the median duration of CPAP support was 50% shorter in the infants on bubble CPAP. Moreover, in the subset of infants who were ventilated for less than 14 days, the infants on bubble CPAP had a significantly lower extubation failure rate. There was no difference in the incidence of chronic lung disease or other complications between the 2 study groups. CONCLUSIONS: Bubble CPAP is as effective as IFD CPAP in the post-extubation management of infants with RDS; however, in infants ventilated for < or = 14 days, bubble CPAP is associated with a significantly higher rate of successful extubation. Bubble CPAP also is associated with a significantly reduced duration of CPAP support.
Samir Gupta; Sunil K Sinha; Win Tin; Steven M Donn
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-02-23
Journal Detail:
Title:  The Journal of pediatrics     Volume:  154     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-14     Completed Date:  2009-05-05     Revised Date:  2009-11-16    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  645-50     Citation Subset:  AIM; IM    
Department of Paediatrics and Neonatal Medicine, James Cook University Hospital, Middlesbrough, UK.
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MeSH Terms
Acidosis, Respiratory / epidemiology
Apnea / epidemiology
Chronic Disease
Continuous Positive Airway Pressure / instrumentation*,  methods*
Enterocolitis, Necrotizing / mortality
Infant, Newborn
Infant, Premature*
Lung Diseases / epidemiology
Prospective Studies
Respiratory Distress Syndrome, Newborn / therapy*
Sepsis / epidemiology
Time Factors
Ventilator Weaning
Comment In:
J Pediatr. 2009 Dec;155(6):945-6; author reply 946-7   [PMID:  19914440 ]
J Pediatr. 2009 May;154(5):633-4   [PMID:  19364554 ]

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