Aly H, Milner JD, Patel K, El-Mohandes AAE. Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants? Pediatrics. 2004;114:697-702.

Extremely low-birth-weight infants (ELBW) have been treated with early nasal continuous positive airway pressure (ENCPAP); however, there have been no quantifiable data to show the benefit of the procedure in this group. Data were gathered in a retrospective study of 101 ELBW to see whether the ENCPAP did enhance patient outcomes.

The infants in the study were treated with ENCPAP immediately after delivery using a water-seal CPAP and nasal prongs. If the child showed respiratory distress, they were placed on conventional mechanical ventilation and were no longer part of the study group. In order to make a comparison, the sample was compared to a group of 45 neonates born before ENCPAP was available at that facility.

The finds indicated that there was no difference in whether the ELBW on the CPAP died more frequently and, more important, the rates of bronchopulmonary dysplasia (BPD) declined in neonates who had the CPAP. The number of days on a ventilator was reduced in the CPAP group and their rate of sepsis also was decreased when compared to the control group. While these data appear on the whole to be positive, the CPAP infants had more instances of necrotizing enterocolitis (NEC), which the researchers explained might have been due to the added incidence of abdominal distension, which is frequently seen in the CPAP patient.

Future research should focus on the continued outcomes for ELBW infants who received ENCPAP rather than direct mechanical ventilation.