RANDOMIZED CONTROLLED TRIAL OF DISCONTINUATION OF NASAL-CPAP IN STABLE PRETERM INFANTS BREATHING ROOM AIR

This trial assessed the consequences of discontinuation of nasal-CPAP in stable preterm infants breathing room air. Eighty-eight infants wit h a mean gestational age of 29 (24-33) weeks and a mean birthweight of 1264 (665-2060) g, randomized to either discontinuation of CPAP or it s continuation, were clinically observed and monitored for 6 h by card iorespiratory monitor, pulse oximeter and transcutaneous blood gas mon itor. The abdominal circumference and gastric air and aspirate volumes were measured prior to meals at trial entry and after 6 h. Discontinu ation of CPAP led to a small but significant decrease in oxygenation a t 1 and 6 h. During the trial, five infants in the experimental group required supplemental oxygen and one infant was put back on CPAP owing to excessive apnoeas. Discontinuation of CPAP did not influence the T cPCO2 or the number of apnoeas and bradycardias during the trial, but led to significantly increased respiratory rate, retractions, and flar ing at 6 h. It also led to a significant decrease in the abdominal cir cumference and gastric air volume. Thirty-nine percent of infants were put back on CPAP some time after the trial, mainly because of recurre nt apnoeas and bradycardias. Taking the infant off CPAP during the tri al reduced subsequent use of CPAP.