A comparison of methods of discontinuing nasal CPAP in premature infants

Abstract

ObjectiveThe objective of this study was to determine whether abrupt discontinuation vs gradual wean of nasal CPAP (NCPAP) in infants <30 weeks gestation results in a decreased duration of NCPAP therapy.Study designWe performed a single-center, randomized control trial of premature infants born <30 weeks gestation (n = 66), comparing discontinuation of NCPAP from 6 cmH2O (CWP) (fast wean arm) to discontinuation at 4 CWP, weaning by 1 CWP per day (slow wean arm). The primary outcome was the total number of days on NCPAP or mechanical ventilation. Secondary outcomes included wean failure, growth, length of stay, and related comorbidities.ResultsDuration of NCPAP or mechanical ventilation was longer in the slow wean arm compared to the fast wean arm (17 vs 12 days, p = 0.03). There were no differences observed in secondary outcomes.ConclusionIn weaning NCPAP, abrupt discontinuation may be associated with a shorter duration of positive pressure respiratory support compared to a gradual weaning strategy.