Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature
Shaili Amatya, Deepa Rastogi, Alok Bhutada, Shantanu Rastogi
Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.
Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.
Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.
Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.
World Journal of Pediatrics
preterm
Fingerprint Dive into the research topics of 'Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature'. Together they form a unique fingerprint.
Weaning Medicine & Life Sciences
Premature Infants Medicine & Life Sciences
Continuous Positive Airway Pressure Medicine & Life Sciences
Nose Medicine & Life Sciences
Systematic Reviews Medicine & Life Sciences
Gestational Age Medicine & Life Sciences
Weights and Measures Medicine & Life Sciences
Gastroesophageal Reflux Medicine & Life Sciences
Amatya, S., Rastogi, D., Bhutada, A., & Rastogi, S. (2014). Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature. World Journal of Pediatrics, 11(1), 7-13. https://doi.org/10.1007/s12519-014-0535-4
Weaning of nasal CPAP in preterm infants : who, when and how? a systematic review of the literature. / Amatya, Shaili; Rastogi, Deepa; Bhutada, Alok; Rastogi, Shantanu.
In: World Journal of Pediatrics, Vol. 11, No. 1, 2014, p. 7-13.
Amatya, S, Rastogi, D, Bhutada, A & Rastogi, S 2014, 'Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature', World Journal of Pediatrics, vol. 11, no. 1, pp. 7-13. https://doi.org/10.1007/s12519-014-0535-4
Amatya S, Rastogi D, Bhutada A, Rastogi S. Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature. World Journal of Pediatrics. 2014;11(1):7-13. https://doi.org/10.1007/s12519-014-0535-4
Amatya, Shaili ; Rastogi, Deepa ; Bhutada, Alok ; Rastogi, Shantanu. / Weaning of nasal CPAP in preterm infants : who, when and how? a systematic review of the literature. In: World Journal of Pediatrics. 2014 ; Vol. 11, No. 1. pp. 7-13.
@article{d7d5c0e75aa64c3b8503631863497fad,
title = "Weaning of nasal CPAP in preterm infants: who, when and how? a systematic review of the literature",
abstract = "Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.",
keywords = "continuous positive airway pressure, infants, preterm, systematic review, weaning",
author = "Shaili Amatya and Deepa Rastogi and Alok Bhutada and Shantanu Rastogi",
note = "Publisher Copyright: {\textcopyright} 2014, Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg. Copyright: Copyright 2015 Elsevier B.V., All rights reserved.",
journal = "World Journal of Pediatrics",
publisher = "Institute of Pediatrics of Zhejiang University",
T1 - Weaning of nasal CPAP in preterm infants
T2 - who, when and how? a systematic review of the literature
AU - Amatya, Shaili
AU - Rastogi, Deepa
AU - Bhutada, Alok
AU - Rastogi, Shantanu
N1 - Publisher Copyright: © 2014, Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg. Copyright: Copyright 2015 Elsevier B.V., All rights reserved.
N2 - Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.
AB - Background: There is increased use of early nasal continuous positive airway pressure (NCPAP) to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined. A systematic review was performed to define the corrected gestational age (CGA), weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants, along with factors affecting it.Methods: Searches were made of PubMed using the keywords-NCPAP, CPAP, weaning, withdrawal, preterm, and infants from its inception to January 1st, 2014, for studies in all languages but limited to humans. Previous reviews (including cross references) were also searched. We included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning strategies. Details of CGA, weight and methods used for weaning NCPAP were extracted along with factors which affect its withdrawal.Results: Seven studies met the search criteria. The successful wean was at 32 to 33 weeks CGA and at 1600 g. Three different methods were used for weaning were sudden, gradual pressure wean and gradual graded time off wean. Criteria for readiness, success and failure to wean were defined. Factors affecting successful weaning were intubation, anemia, infection and gastro-esophageal reflux.Conclusions: The successful wean was at 32 to 33 weeks CGA and 1600 g. Criteria for readiness, success and failure to wean are well defined. Sudden weaning may be associated with a shorter weaning time. Future trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.
KW - continuous positive airway pressure
KW - infants
KW - preterm
KW - systematic review
KW - weaning
JO - World Journal of Pediatrics
JF - World Journal of Pediatrics