Ryan Lam1, Diane Schilling1, Brian Scottoline1, Astrid Platteau1, Meike Niederhausen2, Kelli C Lund1, Robert L Schelonka1, Kelvin D MacDonald3, Cindy T McEvoy4. 1. Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR. 2. Biostatistics and Design Program, Oregon Health & Science University-Portland State University School of Public Health, Portland, OR. 3. Division of Pediatric Pulmonology, Oregon Health & Science University, Portland, OR. 4. Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR. Electronic address: mcevoyc@ohsu.edu.
Abstract
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.
RCT Entities:
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.
Authors: Juan E Balinotti; Christina J Tiller; Conrado J Llapur; Marcus H Jones; Risa N Kimmel; Cathy E Coates; Barry P Katz; James T Nguyen; Robert S Tepper Journal: Am J Respir Crit Care Med Date: 2008-11-07 Impact factor: 21.405
Authors: Michael R Harrison; Roberta L Keller; Samuel B Hawgood; Joseph A Kitterman; Per L Sandberg; Diana L Farmer; Hanmin Lee; Roy A Filly; Jody A Farrell; Craig T Albanese Journal: N Engl J Med Date: 2003-11-13 Impact factor: 91.245
Authors: Egidio Beretta; Francesco Romanò; Giulio Sancini; James B Grotberg; Gary F Nieman; Giuseppe Miserocchi Journal: Front Physiol Date: 2021-12-20 Impact factor: 4.566
Authors: Mar Janna Dahl; Chiara Veneroni; Anna Lavizzari; Sydney Bowen; Haleigh Emerson; Andrew Rebentisch; Elaine Dawson; Kyle Summers; Luke Pettet; Zhengming Wang; Donald M Null; Bradley A Yoder; Raffaele L Dellacà; Kurt H Albertine Journal: Am J Physiol Lung Cell Mol Physiol Date: 2021-05-19 Impact factor: 6.011
Authors: Katherine P Sullivan; Heather O White; Lindsay E Grover; Jordi J Negron; Austin F Lee; Lawrence M Rhein Journal: Pediatr Res Date: 2021-01-19 Impact factor: 3.756
Authors: Samuel J Gentle; Benjamin Carper; Matthew M Laughon; Erik A Jensen; Austin Williams; Colm P Travers; Namasivayam Ambalavanan; Charitharth V Lal; Waldemar A Carlo Journal: J Perinatol Date: 2022-01-15 Impact factor: 3.225