Weaning of nasal CPAP in preterm infants

who, when and how? a systematic review of the literature

Shaili Amatya, Deepa Rastogi, Alok Bhutada, Shantanu Rastogi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.

Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.

Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.

Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.

Original languageEnglish (US)
Pages (from-to)7-13
Number of pages7
JournalWorld Journal of Pediatrics
Volume11
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Weaning
Nose
Premature Infants
Continuous Positive Airway Pressure
Gestational Age
Weights and Measures
Gastroesophageal Reflux
PubMed
Intubation
Birth Weight
Anemia
Language
Randomized Controlled Trials
Newborn Infant
Pressure
Infection

Keywords

  • continuous positive airway pressure
  • infants
  • preterm
  • systematic review
  • weaning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Weaning of nasal CPAP in preterm infants : who, when and how? a systematic review of the literature. / Amatya, Shaili; Rastogi, Deepa; Bhutada, Alok; Rastogi, Shantanu.

In: World Journal of Pediatrics, Vol. 11, No. 1, 2014, p. 7-13.

Research output: Contribution to journalArticle

@article{d7d5c0e75aa64c3b8503631863497fad,
title = "Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature",
abstract = "Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.",
keywords = "continuous positive airway pressure, infants, preterm, systematic review, weaning",
author = "Shaili Amatya and Deepa Rastogi and Alok Bhutada and Shantanu Rastogi",
year = "2014",
doi = "10.1007/s12519-014-0535-4",
language = "English (US)",
volume = "11",
pages = "7--13",
journal = "World Journal of Pediatrics",
issn = "1708-8569",
publisher = "Institute of Pediatrics of Zhejiang University",
number = "1",

}

TY - JOUR

T1 - Weaning of nasal CPAP in preterm infants

T2 - who, when and how? a systematic review of the literature

AU - Amatya, Shaili

AU - Rastogi, Deepa

AU - Bhutada, Alok

AU - Rastogi, Shantanu

PY - 2014

Y1 - 2014

N2 - Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.

AB - Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.

KW - continuous positive airway pressure

KW - infants

KW - preterm

KW - systematic review

KW - weaning

UR - http://www.scopus.com/inward/record.url?scp=84925535804&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925535804&partnerID=8YFLogxK

U2 - 10.1007/s12519-014-0535-4

DO - 10.1007/s12519-014-0535-4

M3 - Article

VL - 11

SP - 7

EP - 13

JO - World Journal of Pediatrics

JF - World Journal of Pediatrics

SN - 1708-8569

IS - 1

ER -