BACKGROUND: Nasal continuous positive airway pressure (NCPAP) is frequently used in preterm infants. However, there is no consensus on when and how to wean them from NCPAP. DATA SOURCES: Based on recent publications, we have reviewed the criteria of readiness-to-wean and factors affecting weaning success. A special focus is placed on the methods of weaning from NCPAP in preterm infants. RESULTS: Practical points of when and how to wean from NCPAP in preterm infants are explained. Preterm infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no (or minimal) oxygen requirement. Methods used to wean from NCPAP include: sudden weaning of NCPAP, gradual decrease of NCPAP pressure, graded-timeoff NCPAP (cycling), weaning to high or low flow nasal cannula, and a combination of these methods. The best strategy for weaning is yet to be determined. Cyclingoff NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of weaning. Gradual decrease of NCPAP pressure is more physiological and better tolerated than cycling-off NCPAP. CONCLUSION: Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) is frequently used in preterm infants. However, there is no consensus on when and how to wean them from NCPAP. DATA SOURCES: Based on recent publications, we have reviewed the criteria of readiness-to-wean and factors affecting weaning success. A special focus is placed on the methods of weaning from NCPAP in preterm infants. RESULTS: Practical points of when and how to wean from NCPAP in preterm infants are explained. Preterm infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no (or minimal) oxygen requirement. Methods used to wean from NCPAP include: sudden weaning of NCPAP, gradual decrease of NCPAP pressure, graded-timeoff NCPAP (cycling), weaning to high or low flow nasal cannula, and a combination of these methods. The best strategy for weaning is yet to be determined. Cyclingoff NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of weaning. Gradual decrease of NCPAP pressure is more physiological and better tolerated than cycling-off NCPAP. CONCLUSION: Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.
Authors: Kris R Jatana; Agnes Oplatek; Melanie Stein; Gary Phillips; D Richard Kang; Charles A Elmaraghy Journal: Arch Otolaryngol Head Neck Surg Date: 2010-03
Authors: Ellina Liptsen; Zubair H Aghai; Kee H Pyon; Judy G Saslow; Tarek Nakhla; Jennifer Long; Andrew M Steele; Robert H Habib; Sherry E Courtney Journal: J Perinatol Date: 2005-07 Impact factor: 2.521
Authors: M E Avery; W H Tooley; J B Keller; S S Hurd; M H Bryan; R B Cotton; M F Epstein; P M Fitzhardinge; C B Hansen; T N Hansen Journal: Pediatrics Date: 1987-01 Impact factor: 7.124
Authors: Brett J Manley; Louise S Owen; Lex W Doyle; Chad C Andersen; David W Cartwright; Margo A Pritchard; Susan M Donath; Peter G Davis Journal: N Engl J Med Date: 2013-10-10 Impact factor: 91.245
Authors: Tim Leon Ullrich; Christoph Czernik; Christoph Bührer; Gerd Schmalisch; Hendrik Stefan Fischer Journal: World J Pediatr Date: 2018-03-09 Impact factor: 2.764
Authors: Christina Friis Jensen; Anna Sellmer; Finn Ebbesen; Rasa Cipliene; Anders Johansen; Rikke Monrad Hansen; Jens Peter Nielsen; Olga Hogreffe Nikitina; Jesper Padkær Petersen; Tine Brink Henriksen Journal: JAMA Pediatr Date: 2018-09-01 Impact factor: 16.193