Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Sudden Complete Versus Gradual Weaning From Nasal Continuous Positive Airway Pressure in Preterm Neonates: A Randomized Controlled Trial Publisher



Mohammadizadeh M1 ; Badiei Z1 ; Choopani R2 ; Khalili M3
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
  3. 3. Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Neonatology Published:2019


Abstract

Background: Continuous positive airway pressure (CPAP) is used as respiratory support in preterm neonates; however, the best weaning method has not yet been determined. In this study, we compared sudden complete and gradual weaning from nasal CPAP (NCPAP) in preterm newborns. Methods: This randomized controlled trial was conducted on 62 preterm neonates who were born with a gestational week of < 32 weeks and required NCPAP for at least 24 h. The neonates were stable on NCPAP at 0.21 FiO2 and 5 cm H2O positive end-expiratory pressure. They were randomized into two groups of gradual and sudden weaning using random numbers sheet. The primary outcome was successful weaning at the first attempt. The secondary outcomes included the number of NCPAP weaning attempts, the need for mechanical ventilation (nasal and endotracheal), duration of NCPAP, oxygenation, and length of hospital stay. Results: According to the results, 80.6% of the patients in the sudden weaning group and 74.2% of the patients in the gradual weaning group were weaned successfully in the first attempt. However, there was no statistically significant difference between the two groups in this regard (P=0.54). Duration of NCPAP was significantly lower in the sudden weaning group, compared to that in the gradual weaning group (P<0.001). Numbers of NCPAP weaning attempts, the need for mechanical ventilation, duration of oxygenation, and hospital stay in the two groups were not significantly different. Conclusion: There was no difference between sudden complete and gradual weaning from NCPAP in terms of treatment success and complications. The selection of the appropriate technique may depend on available equipment and treatment costs. © 2019 Mashhad University of Medical Sciences. All rights reserved.
Related Docs
View other Related Docs
1. High Flow Nasal Cannula As a Method for Rapid Weaning From Nasal Continuous Positive Airway Pressure, International Journal of Preventive Medicine (2015)
2. Noninvasive Positive Pressure Ventilation or Conventional Mechanical Ventilation for Neonatal Continuous Positive Airway Pressure Failure, International Journal of Preventive Medicine (2014)
3. Effects of Positioning on Complications of Preterm Infants With Respiratory Distress Syndrome Treated With Nasal Continuous Positive Airway Pressure: A Randomized Clinical Trial, Iranian Journal of Neonatology (2023)
4. High-Flow Nasal Cannula Versus Nasal Continuous Positive Airway Pressure in the Management of Respiratory Distress Syndrome, Journal of Isfahan Medical School (2011)
5. Initial Treatment of Respiratory Distress Syndrome With Nasal Intermittent Mandatory Ventilation Versus Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial, International Journal of Preventive Medicine (2014)
6. Nasal High-Frequency Oscillatory Ventilation (Nhfov) Versus Nasal Continuous Positive Airway Pressure (Ncpap) As an Initial Therapy for Respiratory Distress Syndrome (Rds) in Preterm and Near-Term Infants, BMJ Paediatrics Open (2019)
7. Comparison of Respiratory Complications Between Endotracheal Intubation and Laryngeal Mask Airway (Lma) in Neonates Undergoing Inguinal Herniorrhaphy Under General Anesthesia, Journal of Isfahan Medical School (2017)
8. Heated Humidified High Flow Nasal Cannula (Hhhfnc) Is Not an Effective Method for Initial Treatment of Respiratory Distress Syndrome (Rds) Versus Nasal Intermittent Mandatory Ventilation (Nimv) and Nasal Continuous Positive Airway Pressure (Ncpap), Journal of Research in Medical Sciences (2019)
Experts (# of related papers)
View all Related Experts
Alireza Sadeghnia (13)
Amir-Mohammad Armanian (10)
Other Related Docs
9. Early Administration of Surfactant Via a Thin Intratracheal Catheter in Preterm Infants With Respiratory Distress Syndrome: Feasibility and Outcome, Journal of Research in Pharmacy Practice (2015)
10. Compare the Effects of Continuous Positive Airway Pressure With Two Different Methods to Treat Premature Infants With Respiratory Distress Syndrome, Journal of Isfahan Medical School (2011)
11. A Comparison of the Effect of Nasal Bi‑Level Positive Airway Pressure and Sigh‑Positive Airway Pressure on the Treatment of the Preterm Newborns Weighing Less Than 1500 G Affiliated With Respiratory Distress Syndrome, International Journal of Preventive Medicine (2016)
12. Sleep-Wake Cycle in Newborns With 28-32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation, Iranian Journal of Pediatrics (2022)
13. Protective Dressings, Injury, and Device Failure in Preterm Infants Receiving Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial, Advances in Skin and Wound Care (2021)
14. Evaluation the Effect of Breathing Filters on End-Tidal Carbon Dioxide During Inferior Abdominal Surgery in Infants and Changes of Tidal Volume and Respiratory Rate Needs for Preventing of Increasing End-Tidal Carbon Dioxide, Journal of Research in Medical Sciences (2016)
15. Comparison of Ventilator’S Work of Breath Cased on Constant Flow Nasal Cpap Through Pressure Limited and Electronic Feedback Pressure Control Mechanisms in the Treatment of Rds in Neonates Weighing About 1000 Grams, Iranian Journal of Pediatrics (2019)
16. Comparison of Surfactant Administration Efficacy in the Treatment of Respiratory Distress Syndrome in Preterm Neonates: Aerosolization Versus Insure, Iranian Journal of Pediatrics (2022)
17. Effect of Prophylactic Caffeine on Noninvasive Respiratory Support in Preterm Neonates Weighing 1250-2000 G: A Randomized Controlled Trial, Archives of Iranian Medicine (2022)
18. Comparison of Comfort and Effectiveness of Total Face Mask and Oronasal Mask in Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure: A Clinical Trial, Canadian Respiratory Journal (2017)
19. Comparison of Respiratory Complications of Propofol and Isoflurane Among Six-Months to Two-Years-Old Infants Undergoing Inguinal Herniorrhaphy Under General Anesthesia With Laryngeal Mask Airway, Journal of Isfahan Medical School (2017)
20. The Rehospitalization Rates of Low-Birth-Weight Infants in Isfahan Shahid Beheshti Hospital, Iran, Journal of Isfahan Medical School (2015)
21. Comparative Evaluation of Therapeutic Approaches to Central Sleep Apnea, Advanced Biomedical Research (2019)
22. A Comparative Study of the Effect of Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure on the Regional Brain Tissue Oximetry in Premature Newborns Weighing <1500 G, International Journal of Preventive Medicine (2017)
23. Can Selection of Mechanical Ventilation Mode Prevent Increased Intra-Abdominal Pressure in Patients Admitted to the Intensive Care Unit?, International Journal of Preventive Medicine (2013)
24. Surfactant Administration Via Thin Catheter During Spontaneous Breathing: Randomized Controlled Trial in Alzahra Hospital, Iranian Journal of Neonatology (2013)
25. The Prevalence of Complications of Prematurity Among 1000 Newborns in Isfahan, Iran, Advanced Biomedical Research (2019)
26. The Duration of Hospitalization and Readmission Rate of Low Birth Weight Infants in a Tertiary Referral Hospital in Isfahan, Iran, Iranian Journal of Neonatology (2015)
27. Comparative Evaluation of Difficult Intubation Predictors in Children Under Two Years of Ages, Anesthesiology and Pain Medicine (2021)
28. Evaluation of the Effects of Surfactant Replacement Therapy in Neonatal Respiratory Distress Syndrome, Chinese Journal of Contemporary Pediatrics (2009)
29. Accuracy of Amniotic Fluid Lamellar Body Counting for Evaluating Fetal Lung Maturity., Medicinski arhiv (2012)
30. Effect of Facilitated Tucking Created With Simulated Hands on Physiological Pain Indicators During Venipuncture in Premature Infants, Iranian Journal of Neonatology (2017)
31. Effect of Different Positions on Arterial Oxygen Saturation During Enteral Feeding of Preterm Infants Admitted to Neonatal Intensive Care Units, Iranian Journal of Neonatology (2020)
32. Evaluation of Ventilation With Nasal Versus Face Mask After General Anesthesia Induction in Pediatric Patients, Anesthesiology and Pain Medicine (2022)
33. Prophylactic Aminophylline for Prevention of Apnea at Higher-Risk Preterm Neonates, Iranian Red Crescent Medical Journal (2014)
34. Predisposing Factors, Incidence and Mortality of Pneumothorax in a Neonatal Intensive Care Unit in Isfahan, Iran, Chinese Journal of Contemporary Pediatrics (2010)
35. High-Flow Nasal Cannula Versus Conventional Oxygen Therapy for Patients With Acute Respiratory Failure in the Emergency Department: A Randomized Controlled Trial, Tanaffos (2024)
36. Resuscitation of Preterm Newborn With High Concentration Oxygen Versus Low Concentration Oxygen, Journal of Isfahan Medical School (2011)
37. Prediction of Difficult Laryngoscopy in Obstetric Patients Scheduled for Caesarean Delivery, European Journal of Anaesthesiology (2008)
38. Effect of Facilitated Tucking With the Nurse and a Simulated Hand on Physiological Pain Index During Vein Puncture on Premature Infants, Journal of Babol University of Medical Sciences (2018)
39. Effect of Intermittent Subglottic Secretion Drainage on Ventilator-Associated Pneumonia: A Clinical Trial, Iranian Journal of Nursing and Midwifery Research (2014)
40. The Effect of Inhaled Budesonide on the Prevention of Chronic Lung Disease in Premature Neonates With Respiratory Distress Syndrome, International Journal of Preventive Medicine (2018)
41. Prognostic Factors of Outcome in Children With Acute Respiratory Distress Syndrome, Journal of Isfahan Medical School (2017)
42. Effects of the Time Interval Between Antenatal Corticosteroid Exposure and Delivery on Neonatal Outcome of Premature Infants, Journal of Isfahan Medical School (2013)
43. The Prognostic Value of Rapid Shallow Breathing Index and Physiologic Dead Space for Weaning Success in Intensive Care Unit Patients Under Mechanical Ventilation, Journal of Research in Medical Sciences (2019)
44. Improving the Ability of Nursing Students in Neonatal Resuscitation by Using the Helping Babies Breathe Program: A Quasi-Experimental Study, Journal of Neonatal Nursing (2023)
45. Risk Factors of Pneumothorax in Preterm Infants, Journal of Isfahan Medical School (2013)
46. Evaluation of Intratracheal Salbutamol Effects in Addition to Surfactant in the Clinical Course of Premature Neonates With Respiratory Distress Syndrome, Journal of Research in Medical Sciences (2023)
47. Early Outcome of Preterm Infants With Birth Weight of 1500 G or Less and Gestational Age of 30 Weeks or Less in Isfahan City, Iran, World Journal of Pediatrics (2010)
48. The Prevalence of Complications of Prematurity Among 1000 Newborns With Weight of Less Than 1500 Grams in University Hospitals in Isfahan City, Iran, Journal of Isfahan Medical School (2018)
49. Comparison of the Weaning Rate in Three Mechanical Ventilation Methods, Automatic Tube Compensation and Pressure Support Ventilation With Airway Pressure of Five and Eight Centimeters of Water, Journal of Isfahan Medical School (2017)