The Effect of Extended Continuous Positive Airway Pressure on Changes in Lung Volumes in Stable Premature Infants: A Randomized Controlled Trial

Ryan Lam, Diane Schilling, Brian Scottoline, Astrid Platteau, Meike Niederhausen, Kelli C. Lund, Robert L. Schelonka, Kelvin D. MacDonald, Cindy T. McEvoy

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4 Scopus citations

Abstract

Objective: To compare changes in lung volumes, as measured by functional residual capacity (FRC), through to discharge in stable infants randomized to 2 weeks of extended continuous positive airway pressure CPAP (eCPAP) vs CPAP discontinuation (dCPAP). Study design: Infants born at ≤32 weeks of gestation requiring ≥24 hours of CPAP were randomized to 2 weeks of eCPAP vs dCPAP when meeting CPAP stability criteria. FRC was measured with the nitrogen washout technique. Infants were stratified by gestational age (<28 and ≥ 28 weeks) and twin gestation. A linear mixed-effects model was used to evaluate the change in FRC between the 2 groups. Data were analyzed blinded to treatment group allocation. Results: Fifty infants were randomized with 6 excluded, for a total of 44 infants. Baseline characteristics were similar in the 2 groups. The infants randomized to eCPAP vs dCPAP had a greater increase in FRC from randomization through 2 weeks (12.6 mL vs 6.4 mL; adjusted 95% CI, 0.78-13.47; P = .03) and from randomization through discharge (27.2 mL vs 17.1 mL; adjusted 95% CI, 2.61-17.59; P = .01). Conclusions: Premature infants randomized to eCPAP had a significantly greater increase in FRC through discharge compared with those randomized to dCPAP. An increased change in FRC may lead to improved respiratory health. Trial registration: ClinicalTrials.gov: NCT02249143.

Original languageEnglish (US)
Pages (from-to)66-72.e1
JournalJournal of Pediatrics
Volume217
DOIs
StatePublished - Feb 2020

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Keywords

  • continuous positive airway pressure
  • functional residual capacity
  • premature

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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