Continuous positive airway pressure (CPAP) weaning trial
- Conditions
- Babies who are on constant continuous positive airway pressure (CPAP) support need to have the CPAP weaned in order to allow the babies to breathe without support.Reproductive Health and Childbirth - Childbirth and postnatal care
- Registration Number
- ACTRN12606000155594
- Lead Sponsor
- Dr David Todd
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Active, not recruiting
- Sex
- All
- Target Recruitment
- 200
1.All babies <30 weeks gestational age 2.On CPAP for >24 hours 3.Babies either extubated to CPAP or as a primary treatment for respiratory distress Criteria for commencing weaning: Babies must have all of the following for the past 12 hours:- 1.CPAP <6 cm H2O 2.Oxygen requirement less than 26% and not increasing 3.RR less than 60 4.No significant chest recession 5.Less than 3 episodes of mild self reverting apnoeas and/or bradycardias and/or desaturations in 1 hour for the previous 6 hours 6.Average saturation above 87% most of the time and/or transcutaneous (TcPO2)/arterial PaO2 >50 mm Hg. 7.Tolerates nose rests well during nursing cares 8.Not treated for patent ductus arteriosus (PDA) or sepsis Criteria for failed trial OFF” at least 2 of the following:- 1.Increase work of breathing (Intercostal recession and accessory muscles contributing for respiration) with RR >75 for >1 hour 2.Increased apnoeas and/or bradycardias and/or desaturations >2 in previous 1 hour 3.Major apnoea or bradycardia requiring more sustained stimulation/ resuscitation 4.Increased O2 requirement >25% with average saturation <85% and/or TcPO2/PaO2 <45mmHg 5.pH of <7.2 6.PaCO2 of > 65 mmHg. The babies will be put back on CPAP if failed trial OFF” CPAP. If a baby has a major apnoea and/or bradycardia requiring resuscitation they may require intubation and ventilation.
1. If congenital respiratory abnormality including central and anatomical.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Reduction in time of respiratory support. For methods 1 and 2 this will be 24 hours OFF CPAP and for those in method 3, this will be 24 hours OFF nasal cannula. So the time on CPAP will be from the time commenced CPAP to OFF support.[5 days after OFF CPAP.]
- Secondary Outcome Measures
Name Time Method Reduction in Chronic Lung Disease (CLD) rate defined as requiring oxygen at 36 weeks post conceptional age[36 Weeks post conceptional age.];Reduction in admission time[At discharge to home.]