Jornal de Pediatria ISSN 1678-4782 Volume 87 N° 6 Nov/Dec 2011

Original Article

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

CPAP em selo d’água versus CPAP com fluxo variável em recém-nascidos com desconforto respiratório: um ensaio controlado randomizado

Ana Cristina Zanon Yagui, Luciana Assis Pires Andrade Vale, Luciana Branco Haddad, Cristiane Prado, Felipe de Souza Rossi, Alice D’Agostini Deutsch, Celso Moura Rebello  •  http://dx.doi.org/10.2223/JPED.2145
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J Pediatr (Rio J). 2011;87(6):499-504: Infant, newborn, ventilation, neonatal intensive care units.


  

Objective: 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.
Methods: 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.
Results: 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).
Conclusion: 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.

Authors
Ana Cristina Zanon Yagui
MD. Physiotherapist. Department of Maternal and Child, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Luciana Assis Pires Andrade Vale
Physiotherapist. Department of Maternal and Child, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Luciana Branco Haddad
MD. Physiotherapist. Department of Maternal and Child, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Cristiane Prado
Physiotherapist. Department of Maternal and Child, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Felipe de Souza Rossi
MD. Physician. Neonatal Intensive Care Unit (NICU), Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Alice D’Agostini Deutsch
PhD. Physician. NICU, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Celso Moura Rebello
PhD. Physician. NICU, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,

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