Continuous Positive Airway Pressure Therapy for Infants With Respiratory Distress in Non–Tertiary Care Centers: A Randomized, Controlled Trial

Buckmaster, Adam; Arnolda, Gaston; Wright, Ian; Foster, Jann P; Henderson‐Smart, David J

doi:10.1542/peds.2007-0775

Cited by 76 publications

(80 citation statements)

References 20 publications

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“…The simplicity and low cost of BCPAP delivery system compared with ventilators makes it an attractive option for neonatal intensive care units in resource-poor setups where management as well as referral to tertiary care centers impose a significant economic burden [14].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Comparison of BCPAP vs. VCPAP in Preterm Infants with Early Onset Respiratory Distress

Tagare¹,

Vaidya²,

Pandit³

et al. 2009

Journal of Tropical Pediatrics

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SummaryBackground: Bubble continuous positive airway pressure (BCPAP) is a low-cost nasal CPAP delivery system with potential benefits for developing nations. The objective of the study was to compare the efficacy and safety of BCPAP with ventilator CPAP (VCPAP) in preterm neonates with moderate respiratory distress. Methods: In a pilot randomized controlled trial, 30 preterm neonates (gestation <37 weeks) with Silverman-Anderson score between 5 to 7 and oxygen requirement >30% within first 6 h of life were randomly allocated to BCPAP or VCPAP after informed parental consent. Proportion of neonates with success or failure, while using the allocated mode of CPAP delivery (primary outcome) was compared. Results: The success rate was comparable [VCPAP: 80% (12/15) vs. BCPAP: 87% (13/15)] between the two groups. Dislodgement was commonest problem with equal frequency [10/15, (67%)] in each group. Conclusion: BCPAP appears to be a promising method of CPAP delivery in preterm neonates with moderate respiratory distress.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study of Comparison of BCPAP vs. VCPAP in Preterm Infants with Early Onset Respiratory Distress

Tagare¹,

Vaidya²,

Pandit³

et al. 2009

Journal of Tropical Pediatrics

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“…These methods are now used if possible as a substitute for MV in babies with RDS as they are less injurious to the lung [73] . The earlier CPAP is applied the greater the chance of avoiding MV, and when applied from birth CPAP reduces the need for surfactant therapy and MV [36,37,74] , and the need for tertiary transfer of babies with mild RDS may be avoided [75] . CPAP reduces the need for reintubation if applied following extubation from MV and at least 5 cm H 2 O pressure appears to be needed to achieve this [76] .…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants - 2013 Update

et al. 2013

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Despite recent advances in the perinatal management of neonatal respiratory distress syndrome (RDS), controversies still exist. We report updated recommendations of a European Panel of expert neonatologists who developed consensus guidelines after critical examination of the most up-to-date evidence in 2007 and 2010. This second update of the guidelines is based upon published evidence up to the end of 2012. Strong evidence exists for the role of antenatal steroids in RDS prevention, but it is still not clear if the benefit of repeated courses on respiratory outcomes outweighs the risk of adverse outcomes in the short and long term. Many practices involved in preterm neonatal stabilization at birth are not evidence based, including oxygen administration and positive pressure lung inflation, and they may at times be harmful. Surfactant replacement therapy is crucial in the management of RDS but the best preparation, optimal dose and timing of administration at different gestations is not completely clear. In addition, use of very early continuous positive airway pressure (CPAP) has altered the indications for prophylactic surfactant administration. Respiratory support in the form of mechanical ventilation may be lifesaving but can cause lung injury, and protocols should be directed at avoiding mechanical ventilation where possible by using non-invasive respiratory support such as CPAP. For babies with RDS to have best outcomes, it is essential that they have optimal supportive care, including maintenance of normal body temperature, proper fluid management, good nutritional support, appropriate management of the ductus arteriosus and support of the circulation to maintain adequate tissue perfusion.

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“…The earlier CPAP is applied, the greater the chance of avoiding MV (RR 0.55; 95% CI 0.32-0.96; NNT 6) [77] . When applied from birth, CPAP reduces the need for surfactant therapy and MV [43] , and can potentially reduce the need for tertiary transfer of babies with mild RDS [78] . However, by not using surfactant the baby is exposed to a greater risk of developing a pneumothorax [43,78] .…”

Section: Role Of Cpap In Management Of Rdsmentioning

confidence: 99%

“…When applied from birth, CPAP reduces the need for surfactant therapy and MV [43] , and can potentially reduce the need for tertiary transfer of babies with mild RDS [78] . However, by not using surfactant the baby is exposed to a greater risk of developing a pneumothorax [43,78] . CPAP reduces the need for reintubation if applied following extubation from MV and at least 5 cm H 2 O pressure appears to be needed to achieve this [79] .…”

Section: Role Of Cpap In Management Of Rdsmentioning

confidence: 99%

European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2010 Update

Sweet

Carnielli²,

Greisen³

et al. 2010

Neonatology

234

175

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These updated guidelines contain new evidence from recent Cochrane reviews and the medical literature since 2007. Many of the previous recommendations regarding early surfactant and CPAP are now more firmly evidence-based. The section on delivery room stabilisation has been considerably expanded. There are new recommendations on delaying umbilical cord clamping and a new section has been added on avoiding or reducing duration of mechanica l ventilation, including recommendations on caf feine t herapy, nasal ventilation, permissive hypercapnia and the role of newer ventilator modalities. A new 'miscellaneous' section has also been added covering aspects of RDS management that arise infrequently.© For permitted use only.

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Continuous Positive Airway Pressure Therapy for Infants With Respiratory Distress in Non–Tertiary Care Centers: A Randomized, Controlled Trial

Cited by 76 publications

References 20 publications

A Pilot Study of Comparison of BCPAP vs. VCPAP in Preterm Infants with Early Onset Respiratory Distress

A Pilot Study of Comparison of BCPAP vs. VCPAP in Preterm Infants with Early Onset Respiratory Distress

European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants - 2013 Update

European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2010 Update

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