Early variable-flow nasal continuous positive airway pressure in infants ⩽1000 grams at birth

Objective: To compare the incidence of chronic lung disease (CLD) in extremely low birth weight (ELBW, ⩽1000 g) infants before and after the introduction of early, preferential application of nasal continuous airway pressure (NCPAP) utilizing a variable flow delivery system. Study design: A retrospective cohort study of ELBW infants 2 years prior to (Pre-early NCPAP, n =96) and 2 years following (Early NCPAP, n =75) the initiation of an early NCPAP policy. Results: There were no significant changes (Pre-early NCPAP vs Early NCPAP) in the incidences of CLD (35 vs 33%, P =0.81) or CLD or death (50 vs 43%, P =0.34). Infants in the Early NCPAP group weaned off mechanical ventilation and supplemental oxygen more rapidly than infants in the Pre-early NCPAP group (hazard ratio (HR) 1.80, P =0.002 and HR 1.69, P =0.01). Conclusion: A policy of early NCPAP has not decreased the incidence of CLD despite a decrease in time to successful tracheal extubation.