The Journal of Pediatrics
Volume 154, Issue 5 , Pages 645-650.e2 , May 2009

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

  • Samir Gupta, MD

      Affiliations

    • Department of Paediatrics and Neonatal Medicine, James Cook University Hospital, Middlesbrough, UK
    • ,
  • Sunil K. Sinha, MD, PhD

      Affiliations

    • Department of Paediatrics and Neonatal Medicine, James Cook University Hospital, Middlesbrough, UK
    • Corresponding Author InformationReprint requests: Sunil Sinha, University of Durham and James Cook University Hospital, Middlesbrough, TS4 3BW UK
    • ,
  • Win Tin, MD

      Affiliations

    • Department of Paediatrics and Neonatal Medicine, James Cook University Hospital, Middlesbrough, UK
    • ,
  • Steven M. Donn, MD

      Affiliations

    • Department of Pediatrics, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI

Received 29 August 2008 ,Revised 7 November 2008 ,Accepted 12 December 2008.

References 

  1. Donn SM, Sinha SK. Minimising ventilator-induced lung injury in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2006;91:F226–F230
  2. Ammari A, Suri M, Milisavljevic V, Sahni R, Bateman D, Sanocka U, et al. Variables associated with the early failure of nasal CPAP in very low birth weight infants. J Pediatr. 2005;147:341–347
  3. De Paoli AG, Morley C, Davis PG. Nasal CPAP for neonates: what do we know in 2003?. Arch Dis Child Fetal Neonatal Ed. 2003;88:F168–F172
  4. Davis PG, Henderson-Smart DJ. Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants. Cochrane Database Syst Rev. 2003;(2):CD000143
  5. Product literature: Infant Flow Driver CPAP. Sussex, UK: Electro Medical Equipment Ltd. http://www.viasyshealthcare.com/about/product-29-45420.pdfAccessed November 5, 2008
  6. Courtney SE, Barrington KJ. Continuous positive airway pressure and noninvasive ventilation. Clin Perinatol. 2007;34:73–92vi
  7. Product literature: bubble CPAP. Auckland, New Zealand: Fisher and Paykell Health Care http://www.fphcare.co.nz/neonatal/pdfs/185043599.pdfAccessed November 5, 2008
  8. Pillow JJ, Hillman N, Moss TJ, Polglase G, Bold G, Beaumont C, et al. Bubble continuous positive airway pressure enhances lung volume and gas exchange in preterm lambs. Am J Respir Crit Care Med. 2007;176:63–69
  9. De Paoli AG, Davis PG, Faber B, Morley CJ. Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates. Cochrane Database Syst Rev. 2002;(4):CD002977
  10. Wilson BJ, Becker MA, Linton ME, Donn SM. Spontaneous minute ventilation predicts readiness for extubation in mechanically ventilated preterm infants. J Perinatol. 1998;18:436–439
  11. Gillespie LM, White SD, Sinha SK, Donn SM. Usefulness of the minute ventilation test in predicting successful extubation in newborn infants: a randomized controlled trial. J Perinatol. 2003;23:205–207
  12. Singh J, Sinha SK, Clarke P, Byrne S, Donn SM. Mechanical ventilation of very low birth weight infants: is volume or pressure a better target variable?. J Pediatr. 2006;149:308–313
  13. Sun SC, Tien HC, Banabas S. Randomized controlled trial of two methods of nasal CPAP (NCPAP): flow driver versus conventional CPAP [abstract]. Pediatr Res. 1999;45:322A
  14. Roukema H, O'Brian K, Nesbitt K. A crossover trial of Infant Flow (IF) continuous positive airway pressure (CPAP) versus nasopharyngeal (NP) CPAP in the extubation of babies ≤ 1250 grams birth weight [abstract]. Pediatr Res. 1999;45:318A
  15. Stefanescu BM, Murphy W, Hansell BJ, Fuloria M, Morgan T, et al. A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants. Pediatrics. 2003;112:1031–1038
  16. Morley CJ, Lau R, De Paoli A, Davis PG. Nasal continuous positive airway pressure: does bubbling improve gas exchange?. Arch Dis Child Fetal Neonatal Ed. 2005;90:F343–F344
  17. Lee KS, Dunn MS, Fenwick M, Shennan AT. A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation. Biol Neonate. 1998;73:69–75
  18. Pillow JJ, Travadi JN. Bubble CPAP: is noise important? (An in vitro study). Pediatr Res. 2005;57:826–830
  19. Courtney SE, Pyon KH, Saslow JG, Arnold GK, Pandit PB, Habib RH. Lung recruitment and breathing pattern during variable versus continuous flow nasal continuous positive airway pressure in premature infants: an evaluation of three devices. Pediatrics. 2001;107:304–308
  20. Liptsen E, Aghai ZH, Pyon KH, Saslow JG, Nakhla T, Long J, et al. Work of breathing during nasal continuous positive airway pressure in preterm infants: a comparison of bubble vs variable-flow devices. J Perinatol. 2005;25:453–458
  21. Aly H, Milner JD, Patel K, El M, Ayman AE. Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants?. Pediatrics. 2004;114:697–702

 The authors declare no conflicts of interest.

 Trial registration number: ISRCTN 83339638.

PII: S0022-3476(08)01131-1

doi: 10.1016/j.jpeds.2008.12.034

The Journal of Pediatrics
Volume 154, Issue 5 , Pages 645-650.e2 , May 2009

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