Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial
نویسندگان
چکیده
This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.
منابع مشابه
Early Nasal Intermittent Positive Pressure Ventilation (NIPPV) versus Nasal Continuous Positive Airway Pressure (NCPAP) for Respiratory Distress Syndrome (RDS) in Infants of 28-36 weeks gestational age: a Randomized Controlled Trial
Background: Early nasal continuous positive airway pressure (NCPAP) has emerged as a primary modality of respiratory support for preterm infants withrespiratory distress syndrome (RDS). However, 30%-40% of these newborns need subsequent mechanical ventilation. Nasal intermittent positive pressure ventilation (NIPPV) is a promising alternative to NCPAP, especially in po...
متن کاملComparison of Nasal Continuous Positive Airway Pressure Therapy with and without Prophylactic Surfactant in Preterm Neonates
Background: Preterm labor is at risk for respiratory distress syndrome (RDS) and sometimes requires to mechanical ventilation (MV) and surfactant therapy. Continuous positive airway pressure (CPAP) and Nasal Continuous positive airway pressure (NCPAP) are the methods of respiratory support especially for using in RDS of neonates. In other method surfactant is administered to babies via tracheal...
متن کاملEffectiveness of Nasal Intermittent Positive Pressure Ventilation versus Nasal Continuous Positive Airway Pressure in Preterm Infants after Less Invasive Surfactant Administration
Background Non-invasive ventilation is increased used in preterm infants. We aimed to compare the effectiveness of nasal intermittent positive pressure ventilation (nIPPV) versus nasal continuous positive airway pressure (nCPAP) in preterm infants with respiratory distress syndrome (RDS) after less invasive surfactant administration (LISA). Materials and Methods In this clinical trial, eighty ...
متن کاملHigh Flow Nasal Cannulae versus Nasal Continuous Positive Airway Pressure in Neonates with Respiratory Distress Syndrome Managed with INSURE Method: A Randomized Clinical Trial
Background: In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation).Methods: A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in thi...
متن کاملSudden Complete Versus Gradual Weaning from Nasal Continuous Positive Airway Pressure in Preterm Neonates: A Randomized Controlled Trial
Background: Continuous positive airway pressure (CPAP) is used as respiratory support in preterm neonates; however, the best weaning method has not yet been determined. In this study, we compared sudden complete and gradual weaning from nasal CPAP (NCPAP) in preterm newborns. Methods: This randomized controlled trial was conducted on 62 prete...
متن کاملComparison of the Effects of Prone and Supine Positions on Abdominal Distention in the Premature Infants Receiving Nasal Continuous Positive Airway Pressure (NCPAP)
Background: Premature infants with respiratory distress syndrome (RDS) are in dire need of respiratory support with a ventilator. However, the high tidal volume of mechanical ventilation may cause lung injury, and researchers have been concerned with the use of nasal continuous positive airway pressure (NCPAP). NCPAP has concomitant side effects, such as abdominal distention, which might disrup...
متن کامل