Effects of infant flow Bi-NCPAP on apnea of prematurity

• Published in: Pediatrics international 2016-06, Vol.58 (6), p.456-460
• Main Authors: Ishihara, Chie, Ibara, Satoshi, Ohsone, Yoshiteru, Kato, Eiji, Tokuhisa, Takuya, Yamamoto, Yutaka, Maede, Yoshinobu, Kuwahara, Takako, Minakami, Hisanori
• Format: Article
• Language: English
• Subjects: Adult; Apnea; Apnea - therapy; Babies; bronchopulmonary dysplasia; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; Dermatitis; Extubation; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - therapy; Infants; Intubation, Intratracheal; low birthweight; Mechanical ventilation; methylxanthine; Nose; Pediatrics; Respiratory therapy; Respiratory tract; Retrospective Studies; Sleep apnea; tracheal intubation; Treatment Outcome; Ventilation; Weaning
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.12854

Background Infant flow biphasic nasal continuous positive airway pressure (Bi‐NCPAP) and regular NCPAP (Re‐NCPAP) are equally useful with respect to the rate of successful weaning from mechanical ventilation. It remains unclear, however, whether Bi‐NCPAP or Re‐NCPAP is more effective for reducing apnea of prematurity (AOP). Methods A multicenter randomized controlled study was conducted of 66 infants assigned to receive Bi‐NCPAP and 66 assigned to receive Re‐NCPAP for respiratory support after extubation. Primary outcome was the number of AOP events during the 48 h observation period after successful extubation, defined as no reintubation and no adverse events associated with the use of NCPAP during the observation period. The secondary outcome was successful extubation. Reintubation was at the discretion of the attending physician. Results Baseline characteristics were similar between the two groups. The number of AOP events during the 48 h observation period was significantly lower in infants with Bi‐NCPAP than in those with Re‐NCPAP (5.2 ± 6.5 vs 10.3 ± 10.9 per infant, respectively; P = 0.002). The rate of successful extubation tended to be greater in those with Bi‐NCPAP than in those with Re‐NCPAP (92.4%, 61/66 vs 80.3%, 53/66, respectively; P = 0.074). Adverse events occurred in only one of 132 infants: erosive dermatitis developed on the nose after application of Re‐NCPAP. The risk of reintubation did not differ significantly between the two groups (7.6%, 5/66 for Bi‐NCPAP vs 18.2%, 12/66 for Re‐NCPAP; P = 0.117). Conclusions Bi‐NCPAP was superior to Re‐NCPAP for reduction of AOP following extubation.