Extended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial
Abstract
Rationale Extended continuous positive airway pressure (eCPAP) in the neonatal ICU (NICU) for stable preterm infants increases lung volumes. Its effect on lung growth after discharge is unknown. Objectives To assess whether 2 weeks of eCPAP in stable preterm infants is associated with increased alveolar volume (Va) at 6 months corrected age. Methods This randomized controlled trial was conducted at Oregon Health & Science University. Outpatient assessors were unaware of treatment assignment. One hundred infants were randomized to eCPAP versus CPAP discontinuation (dCPAP) to room air. Measurements and Main Results The primary outcome was Va by the single breath hold technique at 6 months corrected age. Secondary outcomes included DlCO and forced expiratory flows (FEFs). FRC was measured in the NICU. Infants randomized to eCPAP (n = 54) versus dCPAP (n = 46) had the following measurements shown as adjusted mean (SE): Va (500.2 [24.9] vs. 418.1 [23.4] ml; adjusted mean difference, 82.1 [95% confidence interval (CI), 8.3–155.9]; P = 0.033); DlCO (3.4 [0.2] vs. 2.8 [0.1] ml/min/mm Hg; adjusted mean difference, 0.6 [95% CI, 0.1–1.1]; P = 0.018); measurement of FEF at 50% of the expired volume (500.6 [18.2] vs. 437.9 [17.9] ml/s; adjusted mean difference, 62.7 [95% CI, 4.5–121.0]; P = 0.039); FEF between 25% and 75% of expired volume (452.0 [17.4] vs. 394.4 [17.4] ml/s; adjusted mean difference, 57.5 [95% CI, 1.3–113.8]; P = 0.046). Conclusions Infants randomized to eCPAP versus…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 54 participants or records.
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