Bubble CPAP versus CPAP with variable flow in newborns with respiratory distress: a randomized controlled trial

• Published in: Jornal de pediatria Vol. 87; no. 6; pp. 499 - 504
• Main Authors: Yagui, Ana Cristina Zanon, Vale, Luciana Assis Pires Andrade, Haddad, Luciana Branco, Prado, Cristiane, Rossi, Felipe Souza, Deutsch, Alice D Agostini, Rebello, Celso Moura
• Format: Journal Article
• Language: English
• Published: Brazil 01-11-2011
• Subjects: Birth Weight - physiology; Chi-Square Distribution; Continuous Positive Airway Pressure - adverse effects; Continuous Positive Airway Pressure - instrumentation; Continuous Positive Airway Pressure - methods; Female; Humans; Infant, Newborn; Male; Respiratory Distress Syndrome, Newborn - therapy; Statistics, Nonparametric
• ISSN: 0021-7557; 1678-4782
• DOI: 10.2223/JPED.2145

To evaluate the efficacy and safety of nasal continuous positive airway pressure (NCPAP) using devices with variable flow or bubble continuous positive airway pressure (CPAP) regarding CPAP failure, presence of air leaks, total CPAP and oxygen time, and length of intensive care unit and hospital stay in neonates with moderate respiratory distress (RD) and birth weight (BW) ≥ 1,500 g.
Forty newborns requiring NCPAP were randomized into two study groups: variable flow group (VF) and continuous flow group (CF). The study was conducted between October 2008 and April 2010. Demographic data, CPAP failure, presence of air leaks, and total CPAP and oxygen time were recorded. Categorical outcomes were tested using the chi-square test or the Fisher's exact test. Continuous variables were analyzed using the Mann-Whitney test. The level of significance was set at p < 0.05.
There were no differences between the groups with regard to demographic data, CPAP failure (21.1 and 20.0% for VF and CF, respectively; p = 1.000), air leak syndrome (10.5 and 5.0%, respectively; p = 0.605), total CPAP time (median: 22.0 h, interquartile range [IQR]: 8.00-31.00 h and median: 22.0 h, IQR: 6.00-32.00 h, respectively; p = 0.822), and total oxygen time (median: 24.00 h, IQR: 7.00-85.00 h and median: 21.00 h, IQR: 9.50-66.75 h, respectively; p = 0.779).
In newborns with BW ≥ 1,500 g and moderate RD, the use of continuous flow NCPAP showed the same benefits as the use of variable flow NCPAP.