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Weaning of nasal CPAP in preterm infants:who,when and how?a systematic review of the literature

World Journal of Pediatrics 2015年第1期11卷 7-13页

作者： Shaili Amatya Deepa Rastogi alok.bhutada Shantanu Rastogi Division of Neonatology Maimonides Infants&Children's Hospital4802 Tenth AveK-113Brooklyn NY 11219USA Children's Hospital at Montefiore Albert Einstein College of MedicineBronxNY 10467USA

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 corected gestational age(CGA),weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants,along with factors affecting ***: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 *** reviews(including cross references)were also *** included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning *** of CGA,weight and methods used for weaning NCPAP were extracted along with factors which affect its ***:Seven studies met the search *** successful wean was at 32 to 33 weeks CGA and at 1600 *** different methods were used for weaning were sudden,gradual pressure wean and gradual graded time off *** for readiness,success and failure to wean were *** affecting successful weaning were intubation,anemia,infection and gastro-esophageal ***:The successful wean was at 32 to 33 weeks CGA and 1600 *** for readiness,success and failure to wean are well *** weaning may be associated with a shorter weaning *** 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.

关键词： continuous positive airway pressure infants preterm systematic review weaning

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