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Advantages and disadvantages of different nasal CPAP systems in newborns

Buettiker, V. ; Hug, M. ; Baenziger, O. ; Meyer, C. ; Frey, B.

In: Intensive Care Medicine, 2004, vol. 30, no. 5, p. 926-930

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    Titre
    • Advantages and disadvantages of different nasal CPAP systems in newborns
    Auteur
    • Buettiker, V.. Department of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland
    • Hug, M.. Department of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland
    • Baenziger, O.. Department of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland
    • Meyer, C.. Department of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland
    • Frey, B.. Department of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:314137
    Summary
    Objective: To compare three different systems of continuous positive airway pressure (CPAP): the naso-pharyngeal tube and two-prong systems in newborns, focusing on duration of CPAP, side effects and cost. Design: Randomized clinical study. Patients: Between July 2000 and September 2001 newborns were randomized to three different CPAP systems. Forty infants in two weight groups (>2500g and 1250-2500g; 20 patients in each group) were included. Results: In the group >2500g the median duration of CPAP was 1.1days (range 0.25-14.3days). The median time on a naso-pharyngeal CPAP was 1day (range 0.25-14.3days), on Hudson prongs 1.6days (range 0.5-3.3days) and on the Infant Flow system 0.7days (range 0.3-13.6days; p>0.05 for comparison between groups, Fisher's exact test). With naso-pharyngeal CPAP, 2 patients developed moderate nasal injuries. On Hudson, 2 patients developed moderate and three mild nasal injuries. One patient on the Infant Flow showed mild and one moderate nasal injuries. In the weight group 1250-2500g the median duration of CPAP was 1.1days (range 0.1-7.0days). The median time on the naso-pharyngeal tube was 0.9days (range 0.1-7days), on Hudson prongs 1.1days (range 0.7-6.6days) and on the Infant Flow system 1.3days (range 0.25-5.9days; p>0.05 for comparison between groups, Fisher's exact test). With a naso-pharygeal tube, one infant developed mild and one moderate nasal injuries. On Hudson prongs, two had moderate nasal injuries. On Infant Flow, one newborn showed a severe nasal injury and two mild injuries. None of the patients developed a pneumothorax. Conclusion: The naso-pharyngeal tube is an easy, safe and economical CPAP system usable with every common ventilator. For very low birth weight newborns, a prong system may have advantages