Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial
This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was...
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Divulgação Científica
2014-03-01
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2014000300259&lng=en&tlng=en |
| _version_ | 1811298545709350912 |
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| author | W.A. Goncalves-Ferri F.E. Martinez J.P.S. Caldas S.T.M. Marba S. Fekete L. Rugolo C. Tanuri C. Leone G.A. Sancho M.F.B. Almeida R. Guinsburg |
| author_facet | W.A. Goncalves-Ferri F.E. Martinez J.P.S. Caldas S.T.M. Marba S. Fekete L. Rugolo C. Tanuri C. Leone G.A. Sancho M.F.B. Almeida R. Guinsburg |
| author_sort | W.A. Goncalves-Ferri |
| collection | DOAJ |
| description | This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min. |
| first_indexed | 2024-04-13T06:20:55Z |
| format | Article |
| id | doaj.art-5338cff61e2945769213367b2cc11600 |
| institution | Directory Open Access Journal |
| issn | 1414-431X |
| language | English |
| last_indexed | 2024-04-13T06:20:55Z |
| publishDate | 2014-03-01 |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-5338cff61e2945769213367b2cc116002022-12-22T02:58:38ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research1414-431X2014-03-0147325926410.1590/1414-431X20133278S0100-879X2014000300259Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trialW.A. Goncalves-FerriF.E. MartinezJ.P.S. CaldasS.T.M. MarbaS. FeketeL. RugoloC. TanuriC. LeoneG.A. SanchoM.F.B. AlmeidaR. GuinsburgThis study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2014000300259&lng=en&tlng=enContinuous positive airway pressure (CPAP) ventilationPreterm infantsDelivery roomNasal CPAPPrematurity |
| spellingShingle | W.A. Goncalves-Ferri F.E. Martinez J.P.S. Caldas S.T.M. Marba S. Fekete L. Rugolo C. Tanuri C. Leone G.A. Sancho M.F.B. Almeida R. Guinsburg Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial Brazilian Journal of Medical and Biological Research Continuous positive airway pressure (CPAP) ventilation Preterm infants Delivery room Nasal CPAP Prematurity |
| title | Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial |
| title_full | Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial |
| title_fullStr | Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial |
| title_full_unstemmed | Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial |
| title_short | Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial |
| title_sort | application of continuous positive airway pressure in the delivery room a multicenter randomized clinical trial |
| topic | Continuous positive airway pressure (CPAP) ventilation Preterm infants Delivery room Nasal CPAP Prematurity |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2014000300259&lng=en&tlng=en |
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