Neonatology

Original Paper

A Randomized Trial of Low-Flow Oxygen versus Nasal Continuous Positive Airway Pressure in Preterm Infants

Heiring C.a · Steensberg J.b · Bjerager M.c · Greisen G.a

Author affiliations

Departments of aNeonatology and bPediatric Cardiology, Rigshospitalet, Copenhagen, and cDepartment of Pediatrics, Nordsjællands Hospital, Hillerød, Denmark

Keywords: Nasal continuous positive airway pressureLow-flow oxygenNasal cannulaArterial/alveolar oxygen tension ratioLung functionBronchopulmonary dysplasia

Related Articles for ""
Neonatology 2015;108:259-265
https://doi.org/10.1159/000437203

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 31, 2015
Accepted: June 25, 2015
Published online: August 28, 2015
Issue release date: November 2015

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Background: Nasal continuous positive airway pressure (nCPAP) stabilizes the residual volume and may decrease the risk of ‘atelectotrauma', potentially promoting lung development in neonates. Objectives: To assess whether replacing nCPAP by low-flow O2 by nasal cannula affects lung function expressed as the arterial/alveolar oxygen tension ratio (a/A pO2 ratio) on postnatal day 28. Methods: Preterm infants (birth weight <1,500 g and gestational age, GA >26 + 0 weeks) stable on nCPAP between postnatal days 4 and 7 were randomized to nCPAP or low-flow O2 by nasal cannula (<0.2 liters/min). Study criteria defined how to wean/restart respiratory support or change from low-flow O2 to nCPAP and vice versa. Transcutaneous monitoring was used for the assessment of the a/A pO2 ratio on day 28 using a head box for all infants for accurate measurement and to eliminate possible effects from nCPAP or low-flow O2 on oxygen requirement. Results: We enrolled 52 infants (nCPAP group n = 30 and low-flow O2 group n = 22). The a/A pO2 ratio at 28 days was 0.43 ± 0.17 (nCPAP group) versus 0.48 ± 0.18 (p = 0.36). The duration of nCPAP was 16.4 (low-flow group) versus 41.1 days (nCPAP group), p < 0.001. There was no difference between groups in the fraction needing any respiratory support at 36 weeks' corrected age, length of stay, weight at discharge, and relative weight gain. Conclusions: Replacing nCPAP by low-flow O2 in preterm infants with GA >26 weeks at the end of the first week of life did not seem to affect the a/A pO2 ratio or weight gain negatively. Thus, prolonged nCPAP seems not to have a positive effect on lung function at 28 days of life and replacement by low-flow O2 could reduce the cost of equipment and increase the ease of nursing.

© 2015 S. Karger AG, Basel



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References

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 31, 2015
Accepted: June 25, 2015
Published online: August 28, 2015
Issue release date: November 2015

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 4

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

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2015, Vol.108, No. 4

November 2015

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