OBJECTIVE: To compare the failure rates between Jet continuous positive airway pressure device (J-CPAP-variable flow) and bubble continuous positive airway device (B-CPAP) in preterm infants with respiratory distress. STUDY DESIGN: Preterm newborns < 34 weeks gestation with onset of respiratory distress within 6 h of life were randomized to receive J-CPAP (a variable flow device) or B-CPAP (continuous flow device). A standardized protocol was followed for titration, weaning and removal of CPAP. Pressure was monitored close to the nares in both the devices every 6 hours and settings were adjusted to provide desired CPAP. The primary outcome was CPAP failure rate within 72 h of life. Secondary outcomes were CPAP failure within 7 days of life, need for surfactant post-randomization, time to CPAP failure, duration of CPAP and complications of prematurity. An intention to treat analysis was done. RESULTS: One-hundred seventy neonates were randomized, 80 to J-CPAP and 90 to B-CPAP. CPAP failure rates within 72 h were similar in infants who received J-CPAP and in those who received B-CPAP (29 versus 21%; relative risks 1.4 (0.8 to 2.3), p = 0.25). Mean (95% confidence intervals) time to CPAP failure was 59 h (54 to 64) in the Jet CPAP group in comparison with 65 h (62 to 68) in the bubble CPAP group (log rank p = 0.19). All other secondary outcomes were similar between the two groups. CONCLUSION: In preterm infants with respiratory distress starting within 6 h of life, CPAP failure rates were similar with jet CPAP and bubble CPAP.
Reprinted by permission from Journal of Perinatology, Macmillan Publishers Ltd.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher