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CPAP may be better than intubation and surfactant for oxygen delivery
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Continuous positive airway pressure may be a superior alternative to intubation or surfactant to deliver oxygen to preterm infants, according to recently published study results.
Members of the SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network conducted a 4-year study that randomly assigned 1,316 preterm infants to receive one of two oxygen treatments: intubation and surfactant treatment within an hour of birth or Continuous positive airway pressure (CPAP) treatment in the delivery room followed by limited ventilation for 2 weeks.
The researchers noted that infants who received the CPAP treatment, as compared with infants who received surfactant treatment, “less frequently required intubation or postnatal corticosteroids for bronchopulmonary dysplasia (P<.001), required fewer days of mechanical ventilation (P=.03), and were more likely to be alive and free from the need for mechanical ventilation by day 7 (P=.01).”
The researchers also sought to determine the range of oxygen saturation needed to minimize retinopathy of prematurity (ROP).
It was noted that the preterm infants who achieved between 85% and 89% oxygen saturation in their blood had the lowest risk of ROP.
“More research is needed to determine what is a safe lower level of oxygen saturation to either prevent or ameliorate ROP,” Pablo Sanchez, MD, professor of pediatrics at UT Southwestern, said in a press release. “Until then, physicians should be cautious about targeting low oxygen saturation levels because it may lead to a higher chance of death.”
The study was funded by the NIH.
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