Abstract
Background
Continuous positive airway pressure (CPAP) is widely used in preterm infants. Identification of readiness for weaning from CPAP can balance benefits with risks of CPAP exposure. We tested the hypothesis that preterm infants that successfully transition off CPAP have higher oxygen saturations prior to weaning compared with infants who fail weaning from CPAP.
Methods
This was a single-center-matched case–control study in infants ≤30 weeks’ gestation receiving ≤30% FiO2 weaned off CPAP during the first postnatal week. Cases were infants placed back on CPAP within 7 days of being taken off CPAP, whereas control infants remained off CPAP for 7 consecutive days following CPAP discontinuation. Infants were matched on gestational age at birth (±10 days). Prospectively collected histograms detailing the distribution of oxygen saturations prior to CPAP discontinuation were compared between cases and controls.
Results
Over a 12-month monitoring period, 36 infants met inclusion criteria. Baseline characteristics, morbidities, and clinical variables did not differ between cases and controls. Controls achieved oxygen saturations of 95–97 and 97–100% for longer duration compared to cases (p < 0.05).
Conclusions
In preterm infants with RDS receiving CPAP and ≤30% FiO2, infants with higher oxygen saturations had greater success in transitioning off CPAP.
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Samuel J. Gentle, MD Dr. Gentle made substantial contributions to the concept and design, analysis, and interpretation of data. Dr. Gentle lead drafting of the manuscript and manuscript revision critically important to intellectual content. Dr. Gentle provided final approval of the version of the manuscript being submitted. Namasivayam Ambalavanan, MD Dr. Ambalavanan made substantial contributions to the concept and design, analysis, and interpretation of data. Dr. Ambalavanan contributed to drafting of the manuscript and manuscript revision critically important to intellectual content. Dr. Ambalavanan provided final approval of the version of the manuscript being submitted. Waldemar A Carlo, MD Dr. Carlo made substantial contributions to the concept and design, analysis, and interpretation of data. Dr. Carlo contributed to drafting of the manuscript and manuscript revision critically important to intellectual content. Dr. Carlo provided final approval of the version of the manuscript being submitted.
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Gentle, S.J., Ambalavanan, N. & Carlo, W.A. Oxygen saturation histograms predict nasal continuous positive airway pressure-weaning success in preterm infants. Pediatr Res 88, 637–641 (2020). https://doi.org/10.1038/s41390-020-0772-2
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DOI: https://doi.org/10.1038/s41390-020-0772-2
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