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CPAP weaning method: Effect on feeding, caffeine use and weight gain

Presented at the Neonatal Society 2012 Summer Meeting.

Todd DA1, Ying L1, Wright A2, Broom M3, Stewart A4, Shadbolt B1,5

1 Australian National University Medical School, Woden, ACT, Australia
2 Centre for Newborn Care (CNC), Westmead Hospital, Westmead, NSW, Australia
3 Department of Neonatology, Canberra Hospital, Garran, ACT, Australia
4 Grantley Stable Neonatal intensive care unit, Royal Brisbane and Women’s Hospital, QLD, Australia
5 Centre for Advances in Epidemiology and IT, Canberra Hospital Garran, ACT, Australia

Background: A multicentre RCT (Ref) completed in 2009 showed that taking preterm infants (PI’s) off CPAP once reaching stability criteria significantly reduced CPAP weaning time, CPAP time, oxygen requirement and CLD and length of admission. However, taking these babies off CPAP earlier may have a detrimental affect on time to full feeds, cessation of caffeine and weight gain.

Methods: Post hoc analysis of a multicentre RCT of PI’s <30 weeks gestation that compared three different CPAP weaning methods (M1: taken off with the intention of staying off; M2: cycled gradually off; M3: cycled off gradually and with low flow oxygen during cycling off periods). Using generalised linear models with repeated measures and Tweedie model with a log link function these CPAP weaning methods were compared in terms of their effects on: 1. Time to reach full enteral feeds 2. Time to cease caffeine 3. Weight gain over 18 weeks.

Results: 177 PI’s were recruited from April 2006 to October 2009. Data was available from 174 PI’s. Baseline characteristics are shown in the Table. There were no significant differences in corrected gestational age (CGA±1SD) at full feeds, caffeine cessation (Table) or weight gain trends or predicted weight gain between the three methods (data not shown).

CPAP weaning method: Effect on feeding, caffeine use and weight gain

Table: Baseline characteristics and CGA to reach full feeds and cease caffeine

Conclusion: Despite coming off CPAP earlier: time to reach full enteral feeds, time to cease caffeine and weight gain were not affected.

Corresponding author: David.Todd@act.gov.au

Todd et al. Methods of weaning preterm babies <30 weeks gestation off CPAP: A multicentre randomised controlled trial. Arch Dis Child Fetal Neonatal 2012: accepted for publication.

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