N J Robertson1, P A Hamilton. 1. Department of Child Health, St George's Hospital Medical School, London.
Abstract
AIM: To determine if a weaning regimen on flow drivercontinuous positive airway pressure (CPAP) would decrease the number of ventilator days but increase the number of CPAP days when compared with a rescue regimen. METHODS:Fifty eight babies of 24-32 weeks gestation with respiratory distress syndrome (RDS) were studied prospectively. After extubation they were randomly allocated to receive CPAP for 72 hours (n = 29) according to a weaning regimen, or were placed in headbox oxygen and received CPAP only if present "start CPAP" criteria were met (n = 29, rescue group). RESULTS: There was no difference in successful extubation at 72 hours, 1 and 2 weeks, between the groups in terms of the number of reventilation episodes, reventilation days, or in total days of CPAP. Birthweight, gestational age, race, day of first extubation, antenatal or postnatal steroids, patent ductus arteriosus status and maximal mean airway pressure used were of no value in predicting success or failure at 72 hours, 1, or 2 weeks. CONCLUSION: The weaning regimen did not decrease the number of ventilator days or days on CPAP compared with the rescue regimen. The rescue regimen on flow driverCPAP seems to be a safe and effective method of managing a baby of 24-32 weeks gestation who has been ventilated for RDS or immature lung disease.
RCT Entities:
AIM: To determine if a weaning regimen on flow driver continuous positive airway pressure (CPAP) would decrease the number of ventilator days but increase the number of CPAP days when compared with a rescue regimen. METHODS: Fifty eight babies of 24-32 weeks gestation with respiratory distress syndrome (RDS) were studied prospectively. After extubation they were randomly allocated to receive CPAP for 72 hours (n = 29) according to a weaning regimen, or were placed in headbox oxygen and received CPAP only if present "start CPAP" criteria were met (n = 29, rescue group). RESULTS: There was no difference in successful extubation at 72 hours, 1 and 2 weeks, between the groups in terms of the number of reventilation episodes, reventilation days, or in total days of CPAP. Birthweight, gestational age, race, day of first extubation, antenatal or postnatal steroids, patent ductus arteriosus status and maximal mean airway pressure used were of no value in predicting success or failure at 72 hours, 1, or 2 weeks. CONCLUSION: The weaning regimen did not decrease the number of ventilator days or days on CPAP compared with the rescue regimen. The rescue regimen on flow driver CPAP seems to be a safe and effective method of managing a baby of 24-32 weeks gestation who has been ventilated for RDS or immature lung disease.
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: M Mazzella; C Bellini; M G Calevo; F Campone; D Massocco; P Mezzano; E Zullino; F Scopesi; C Arioni; W Bonacci; G Serra Journal: Arch Dis Child Fetal Neonatal Ed Date: 2001-09 Impact factor: 5.747