TY - JOUR
T1 - The Effect of Extended Continuous Positive Airway Pressure on Changes in Lung Volumes in Stable Premature Infants
T2 - A Randomized Controlled Trial
AU - Lam, Ryan
AU - Schilling, Diane
AU - Scottoline, Brian
AU - Platteau, Astrid
AU - Niederhausen, Meike
AU - Lund, Kelli C.
AU - Schelonka, Robert L.
AU - MacDonald, Kelvin D.
AU - McEvoy, Cindy T.
N1 - Publisher Copyright:
© 2019
PY - 2020/2
Y1 - 2020/2
N2 - 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.
AB - 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.
KW - continuous positive airway pressure
KW - functional residual capacity
KW - premature
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U2 - 10.1016/j.jpeds.2019.07.074
DO - 10.1016/j.jpeds.2019.07.074
M3 - Article
C2 - 31519441
AN - SCOPUS:85071954600
SN - 0022-3476
VL - 217
SP - 66-72.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -