Extended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial

dc.contributor.authorMcEvoy, Cindy T.
dc.contributor.authorMacDonald, Kelvin D.
dc.contributor.authorGo, Mitzi A.
dc.contributor.authorMilner, Kristin
dc.contributor.authorHarris, Julia
dc.contributor.authorSchilling, Diane
dc.contributor.authorOlson, Matthew
dc.contributor.authorTiller, Christina
dc.contributor.authorSlaven, James E.
dc.contributor.authorBjerregaard, Jeffrey
dc.contributor.authorVu, Annette
dc.contributor.authorMartin, Alec
dc.contributor.authorMamidi, Rachna
dc.contributor.authorSchelonka, Robert L.
dc.contributor.authorMorris, Cynthia D.
dc.contributor.authorTepper, Robert S.
dc.contributor.departmentPediatrics, School of Medicine
dc.date.accessioned2025-05-15T13:06:22Z
dc.date.available2025-05-15T13:06:22Z
dc.date.issued2025
dc.description.abstractRationale: Extended continuous positive airway pressure (eCPAP) in the neonatal ICU (NICU) for stable preterm infants increases lung volumes. Its effect on lung growth after discharge is unknown. Objectives: To assess whether 2 weeks of eCPAP in stable preterm infants is associated with increased alveolar volume (Va) at 6 months corrected age. Methods: This randomized controlled trial was conducted at Oregon Health & Science University. Outpatient assessors were unaware of treatment assignment. One hundred infants were randomized to eCPAP versus CPAP discontinuation (dCPAP) to room air. Measurements and Main Results: The primary outcome was Va by the single breath hold technique at 6 months corrected age. Secondary outcomes included DlCO and forced expiratory flows (FEFs). FRC was measured in the NICU. Infants randomized to eCPAP (n = 54) versus dCPAP (n = 46) had the following measurements shown as adjusted mean (SE): Va (500.2 [24.9] vs. 418.1 [23.4] ml; adjusted mean difference, 82.1 [95% confidence interval (CI), 8.3-155.9]; P = 0.033); DlCO (3.4 [0.2] vs. 2.8 [0.1] ml/min/mm Hg; adjusted mean difference, 0.6 [95% CI, 0.1-1.1]; P = 0.018); measurement of FEF at 50% of the expired volume (500.6 [18.2] vs. 437.9 [17.9] ml/s; adjusted mean difference, 62.7 [95% CI, 4.5-121.0]; P = 0.039); FEF between 25% and 75% of expired volume (452.0 [17.4] vs. 394.4 [17.4] ml/s; adjusted mean difference, 57.5 [95% CI, 1.3-113.8]; P = 0.046). Conclusions: Infants randomized to eCPAP versus dCPAP had significantly increased Va at 6 months corrected age. DlCO and FEFs were also increased. Extending CPAP in stable preterm infants in the NICU may be a nonpharmacologic and safe therapy to promote lung growth.
dc.eprint.versionFinal published version
dc.identifier.citationMcEvoy CT, MacDonald KD, Go MA, et al. Extended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial. Am J Respir Crit Care Med. 2025;211(4):610-618. doi:10.1164/rccm.202411-2169OC
dc.identifier.urihttps://hdl.handle.net/1805/48160
dc.language.isoen_US
dc.publisherAmerican Thoracic Society
dc.relation.isversionof10.1164/rccm.202411-2169OC
dc.relation.journalAmerican Journal of Respiratory and Critical Care Medicine
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourcePMC
dc.subjectNasal continuous positive airway pressure
dc.subjectPreterm infants
dc.subjectAlveolar volume
dc.subjectLung diffusion capacity
dc.subjectAirway function
dc.titleExtended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial
dc.typeArticle
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