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April 1982

Postextubation Nasal Continuous Positive Airway Pressure: A Prospective Controlled Study

Author Affiliations

From the Departments of Pediatrics (Drs Engelke and Roloff) and Radiology (Dr Kuhns), University of Michigan Medical School, Ann Arbor. Dr Engelke is now with the Department of Pediatrics, East Carolina University School of Medicine, Greenville, NC.

Am J Dis Child. 1982;136(4):359-361. doi:10.1001/archpedi.1982.03970400077020

• Nasal continuous positive airway pressure (N-CPAP), applied immediately after extubation, was prospectively evaluated in 18 neonates recovering from respiratory distress syndrome. Patients were randomly assigned to N-CPAP (group 1, N = 9) or a control group given oxygen by hood (group 2, N = 9). Groups were comparable in birth weight and duration of intubation. In the 24-hour period following extubation, group 1 showed a significantly lower mean respiratory rate (46 ± 2 vs 74 ± 4), alveolar-arterial oxygen gradient (94 ± 9 vs 134 ± 12 mm Hg), Pco2 (45 ± 1 vs 50 ± 1 mm Hg), higher pH (7.33 ± 0.01 vs 7.30 ± 0.01), and less atelectasis by roentgenographic scores. This was associated with considerably better clinical courses in group 1 when compared with group 2, in which six patients required a late trial of N-CPAP because of respiratory deterioration and two patients needed reintubation. Postextubation N-CPAP has a striking beneficial effect on respiratory function and prevention of atelectasis.

(Am J Dis Child 1982;136:359-361)