Comparison of gradual versus sudden weaning of preterm neonates from nasal CPAP
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 7, Issue 1
Abstract
Background: Advantages and disadvantages of CPAP are well known but ideal strategy of weaning from CPAP is still unknown. The point at which neonate is considered stable to attempt weaning from CPAP is also not defined clearly. Aim: Tocompare Gradual Vs Sudden weaning methods in pre-terms on Bubble CPAP. Material and Methods: A total of 91 preterm newborns admitted in NICU and to be weaned from CPAP were randomized in two groups. Babies in one group were weaned by gradual weaning while those in the other group were weaned by sudden weaning. Our primary outcome was to assess the success of both the weaning methods. Secondary outcome was to assess the mortality and morbidities associated with both the weaning methods. Results: Among the babies who succeeded weaning, 44 babies (48.3%) were from the gradual weaning group as compared to 33 (36.2%) in the sudden weaning group. Failure rate was more (14.2%) in the sudden weaning group. Success rate was more (58.2%) in babies with birth weight 1.5-2.5 kgs and gestational age of 32-37 weeks. There was a correlation between failure in weaning from CPAP and high Silverman Anderson score. Conclusion: In our study, we found that, gradual weaning from CPAP with graded time off CPAP was a better weaning method as compared to sudden weaning. Sudden weaning was associated with increased CPAP failure. Implications of our study can be considered while weaning babies from respiratory support.
Authors and Affiliations
Harshal Wagh, Suhas Kumbhar
Keywords
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