Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. 509-518 (doi:10.1542/10.1542/peds.2007-0775)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow An erratum has been published
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Buckmaster, A. G.
Right arrow Articles by Henderson-Smart, D. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Buckmaster, A. G.
Right arrow Articles by Henderson-Smart, D. J.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Continuous Positive Airway Pressure Therapy for Infants With Respiratory Distress in Non–Tertiary Care Centers: A Randomized, Controlled Trial

Adam G. Buckmaster, MBBS, FRACPa,b, Gaston Arnolda, BSc, MPHc, Ian M. R. Wright, MBBS, MRCP, FRACPd, Jann P. Foster, RN, RM, MHScc and David J. Henderson-Smart, MBBS, PhD, FRACPc

a Northern Sydney Central Coast Area Health Service, Gosford Hospital, Gosford, Australia
b Department of Paediatrics
c New South Wales Pregnancy and Newborn Services Network, University of Sydney, Camperdown, Australia
d Mother and Babies Research Centre, Hunter Medical Research Institute, Newcastle, Australia

OBJECTIVE. Our objective was to determine whether continuous positive airway pressure therapy would safely reduce the need for up-transfer of infants with respiratory distress from nontertiary centers.

METHODS. We randomly assigned 300 infants at >30 weeks of gestation with respiratory distress to receive either Hudson prong bubble continuous positive airway pressure therapy or headbox oxygen treatment (standard care). The primary end point was "up-transfer or treatment failure." Secondary end points included death, length of nursery stay, time receiving oxygen therapy, cost of care, and other measures of morbidity.

RESULTS. Of 151 infants who received continuous positive airway pressure therapy, 35 either were up-transferred or experienced treatment failure, as did 60 of the 149 infants given headbox oxygen treatment. There was no difference in the length of stay or the duration of oxygen treatment. For every 6 infants treated with continuous positive airway pressure therapy, there was an estimated cost saving of $10000. Pneumothorax was identified for 14 infants in the continuous positive airway pressure group and 5 in the headbox group. There was no difference in any other measure of morbidity or death.

CONCLUSIONS. Hudson prong bubble continuous positive airway pressure therapy reduces the need for up-transfer of infants with respiratory distress in nontertiary centers. There is a clinically relevant but not statistically significant increase in the risk of pneumothorax. There are significant benefits associated with continuous positive airway pressure use in larger nontertiary centers.

Key Words: continuous positive airway pressure • respiratory insufficiency • infant • newborn • neonatal intensive care • oxygen inhalation therapy • transportation of patients

Abbreviations: CPAP—continuous positive airway pressure • SCN—special-care nursery • NTC—nontertiary center • FIO2—fraction of inspired oxygen

Accepted Apr 13, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?