A Comparison of Moderate to Late Preterm Neonates Receiving Nasal Continuous Positive Airway Pressure in Australian Tertiary and Nontertiary Centers

PurposeTransfer of neonates ≥32 weeks' gestation with acute respiratory distress to tertiary (T) centers can be reduced by treatment with nasal continuous positive airway pressure (nCPAP) in nontertiary (NT) centers. This can lead to considerable financial and emotional benefits. The aim of this project was to compare management of nCPAP in T and NT centers.DesignFive-year retrospective, observational cohort study (2010–2014).SampleAll NT eligible neonates from four sites (n = 484) were compared with a similar randomized cohort of inborn neonates at two T centers (n = 601) in Victoria, Australia.Main outcome variableAny difference in management or short-term outcome.ResultsModerately preterm and term neonates born in NT centers had lower Apgar scores at five minutes of age and received more conservative management delivered by different equipment. Despite a higher incidence of air leaks in NT centers, the short-term outcomes were otherwise similar between centers. T centers were more likely to administer nCPAP to term babies for <24 hours.

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Can mandibular advancement devices be a satisfactory substitute for short term use in patients on nasal continuous positive airway pressure?

Thorax ◽

10.1136/thorax.57.4.305 ◽

2002 ◽

Vol 57 (4) ◽

pp. 305-308 ◽

Cited By ~ 14

Author(s):

D M Smith

Keyword(s):

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Mandibular Advancement ◽

Short Term ◽

Mandibular Advancement Devices

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Randomized Short-term Trial of Two AutoCPAP Devices versus Fixed Continuous Positive Airway Pressure for the Treatment of Sleep Apnea

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/rccm.200304-542oc ◽

2003 ◽

Vol 168 (12) ◽

pp. 1506-1511 ◽

Cited By ~ 41

Author(s):

Oliver Senn ◽

Thomas Brack ◽

Felix Matthews ◽

Erich W. Russi ◽

Konrad E. Bloch

Keyword(s):

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Short Term ◽

Short Term Trial ◽

Term Trial

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Comparison of heated humidified high flow nasal cannula and nasal continuous positive airway pressure after surfactant administration in preterm neonates with respiratory distress syndrome

The Clinical Respiratory Journal ◽

10.1111/crj.13191 ◽

2020 ◽

Vol 14 (8) ◽

pp. 740-747

Author(s):

Zahra Akbarian‐rad ◽

Avishan Mohammadi ◽

Soraya Khafri ◽

Mousa Ahmadpour‐kacho ◽

Yadollah Zahed‐pasha ◽

...

Keyword(s):

Continuous Positive Airway Pressure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Airway Pressure ◽

Distress Syndrome ◽

Positive Airway Pressure ◽

High Flow ◽

Preterm Neonates ◽

High Flow Nasal Cannula ◽

Surfactant Administration

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To Study Effectiveness of Nasal Prong and Nasal Mask in Nasal Continuous Positive Airway Pressure in Preterm Neonates with Respiratory Distress

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i5.32 ◽

2017 ◽

Vol 05 (05) ◽

pp. 21409-21415 ◽

Cited By ~ 4

Author(s):

Dr Gaurav Kumar ◽

Keyword(s):

Continuous Positive Airway Pressure ◽

Respiratory Distress ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Preterm Neonates ◽

Nasal Mask ◽

Nasal Prong

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Continuous Positive Airway Pressure (CPAP) May Not Reduce Short-Term Mortality in Cardiogenic Pulmonary Edema: A Propensity-Based Analysis

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2012.12.006 ◽

2013 ◽

Vol 19 (2) ◽

pp. 108-116 ◽

Cited By ~ 5

Author(s):

Romain Pirracchio ◽

Matthieu Resche Rigon ◽

Alexandre Mebazaa ◽

Faiez Zannad ◽

Francois Alla ◽

...

Keyword(s):

Continuous Positive Airway Pressure ◽

Pulmonary Edema ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Cardiogenic Pulmonary Edema ◽

Short Term ◽

Short Term Mortality

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Comparison between nasal continuous positive airway pressure and mechanical ventilation after surfactant administration in preterm neonates with respiratory distress syndrome

Alexandria Journal of Pediatrics ◽

10.4103/ajop.ajop_15_19 ◽

2019 ◽

Vol 32 (1) ◽

pp. 33

Author(s):

HassanH Hassan ◽

HeshamA Ghazal ◽

MohammedE.A El-Khouly

Keyword(s):

Mechanical Ventilation ◽

Continuous Positive Airway Pressure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Airway Pressure ◽

Distress Syndrome ◽

Positive Airway Pressure ◽

Preterm Neonates ◽

Surfactant Administration

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Bubble versus other continuous positive airway pressure forms: a systematic review and meta-analysis

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-318165 ◽

2020 ◽

Vol 105 (5) ◽

pp. 526-531 ◽

Cited By ~ 2

Author(s):

Shruti K Bharadwaj ◽

Abdullah Alonazi ◽

Laura Banfield ◽

Sourabh Dutta ◽

Amit Mukerji

Keyword(s):

Systematic Review ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Experimental Studies ◽

Preterm Neonates ◽

Close Monitoring ◽

Nasal Injury ◽

Bubble Cpap ◽

Cpap Failure

BackgroundUse of bubble continuous positive airway pressure (CPAP) has generated considerable interest in neonatal care, but its comparative effectiveness compared with other forms of CPAP, especially in developed countries, remains unclear.ObjectiveTo systematically review and meta-analyse short-term clinical outcomes among preterm infants treated with bubble CPAP vs all other forms of CPAP.MethodsProspective experimental studies published from 1995 onward until October 2018 comparing bubble versus other CPAP forms in preterm neonates <37 weeks’ gestational age were included after a systematic review of multiple databases using pre-specified search criteria.ResultsA total of 978 articles were identified, of which 19 articles were included in meta-analyses. Of these, 5 had a high risk of bias, 8 had unclear risk and 6 had low risk. The risk of the primary outcome (CPAP failure within 7 days) was lower with bubble CPAP (0.75; 95% CI 0.57 to 0.98; 12 studies, 1194 subjects, I2=21%). Among secondary outcomes, only nasal injury was higher with use of bubble CPAP (risk ratio (RR) 2.04, 95% CI 1.33 to 3.14; 9 studies, 983 subjects; I2=42%) whereas no differences in mortality (RR 0.82, 95% CI 0.47 to 1.92; 9 studies, 1212 subjects, I2=20%) or bronchopulmonary dysplasia (BPD) (RR 0.8, 95% CI 0.53 to 1.21; 8 studies, 816 subjects, I2=0%) were noted.ConclusionBubble CPAP may lead to lower incidence of CPAP failure compared with other CPAP forms. However, it does not appear to translate to improvement in mortality or BPD and potential for nasal injury warrants close monitoring during clinical application.Trial registration numberCRD42019120411.

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IMPACT OF HIGH LEVELS OF CONTINUOUS POSITIVE AIRWAY PRESSURE ON CARDIAC OUTPUT IN PRETERM NEONATES: A PROSPECTIVE PHYSIOLOGICAL STUDY

Paediatrics & Child Health ◽

10.1093/pch/pxy054.043 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e16-e17

Author(s):

Amit Mukerji ◽

Abdul Gani Muzafar Wahab ◽

Souvik Mitra ◽

Tapas Mondal ◽

Debie Paterson ◽

...

Keyword(s):

Heart Rate ◽

Cardiac Output ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Preterm Neonates ◽

Velocity Time Integral ◽

Time Integral ◽

Postmenstrual Age ◽

Physiological Impact

Abstract BACKGROUND Many NICUs employ high (>8 cmH2O) positive end-expiratory pressures (PEEP) on nasal continuous positive airway pressure (NCPAP) to prevent intubation and associated ventilator-induced lung injury, despite limited safety/efficacy data. OBJECTIVES This study sought to evaluate the physiological impact of high NCPAP PEEP. DESIGN/METHODS Fifteen preterm neonates at postmenstrual age ≥32 weeks (without congenital anomalies or acute intercurrent illness) on NCPAP PEEP of 5 cmH2O were enrolled. PEEP was increased by 2 cmH2O increments until 13 cmH2O. At each increment, following 5 minutes washout, cardiac output (aortic velocity-time integral x heart rate) and cardiorespiratory parameters including blood pressure, heart rate, respiratory rate were measured over 10 minutes. Predefined cut-off values for changes in cardiorespiratory parameters were used as termination criteria. Data are presented as mean (SD), and were compared using one-way ANOVA. RESULTS The mean GA, age at study, and weight of subjects were 27.4 (2.6) weeks, 58.5 (35.5) days, and 2.3 (0.6) kg, respectively. Cardiac output (mL/kg/min) at PEEPs of 5, 7, 9, 11, and 13 cmH2O were not different at 295 (75), 290 (66), 281 (69), 286 (73), and 292 (58), respectively (P=0.986), as shown in Figure 1a. Importantly there were also no differences in either aortic velocity-time integral or heart rate over these PEEP ranges (Figures 1b and 1c). There were no significant differences in cardiorespiratory parameters; no subjects met cut-off criteria. Data collection was terminated in 2 subjects after PEEP 9 cmH2O due to lung over-distension subjectively noted on echocardiogram. CONCLUSION High levels of NCPAP PEEP were well tolerated for short durations. Further physiological and clinical research is required on safety/efficacy in neonates with more severe lung disease, as well as its impact over longer durations.

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