Influence of nasopharyngeal CPAP on breathing pattern and incidence of apnoeas in preterm infants

Continuous positive airway pressure (CPAP) applied by endotracheal (ET) tub e in the pharynx (nasopharyngeal CPAP, n-CPAP) is widely used for the treat ment of mild respiratory distress syndrome and of apnoeas of prematurity. E ffects on breathing pattern a nd on different types of apnoeas are not full y understood. We wanted to know the effect of discontinuing n-CPAP on the r espiratory rate, apnoeas and bradycardia/desaturation events. Thirteen prem aturely born infants with bradycardia and/or desaturation events were studi ed when weaning from n-CPAP was clinically considered. Polygraphic studies were performed for 2h during n-CPAP therapy and for 2 h without CPAP. Nasal flow was measured by registering expiratory pCO(2) at the free nostril ope ning. During n-CPAP, the respiratory rate was significantly lower, there we re fewer obstructive apnoeas, more short central apnoeas (6-9 s) and less s evere apnoea-associated desaturations. During n-CPAP, the infants spent sig nificantly more time in a state of quiet breathing.