Biphasic CPAP vs N-CPAP on gas exchange in preterm infants
Research type
Research Study
Full title
A comparsion of the effects of nasal continuous positive airway pressure(N-CPAP) and nasal biphasic positive airway pressure (n-BiPAP) at equivalent mean airway pressures on carbon dioxide clearance in a population of <30 weeks preterm infants, within the 1st 48 hours following extubation within the first two weeks of life.
IRAS ID
216217
Contact name
Aparajita Basu
Contact email
Sponsor organisation
Manchester University NHS Foundation Trust
Clinicaltrials.gov Identifier
ISRCTN18921778, ISRCTN; PB-PG-0909-19171, NIHR-RFPB; 10/H1016/145, REC REF; 60995/GM, CSP REF
Duration of Study in the UK
0 years, 4 months, 15 days
Research summary
Respiratory distress syndrome is the most significant problem in premature new-born infants. Infants born prematurely particularly less than 30 weeks gestation are more at risk and likely to need ventilatory support in the immediate new-born period. N- CPAP (nasal continuous positive airway pressure) and nasal biphasic positive airway pressure (n-BiPAP) are the commonly used modes of non-invasive respiratory support in this group of patients.
Biphasic CPAP has been shown to confer no advantage compared with flat CPAP for respiratory support following primary extubation in infants below 30 weeks gestation (Victor et al 2015). Small studies have suggested improved CO2 clearance with Biphasic compared with flat CPAP (Migliori 2005) but the comparison has not yet been explored when the support is given at equivalent mean airway pressure, which may significantly affect the results. The EXTUBATE study was a randomised controlled trial comparing the use of Biphasic CPAP with flat CPAP for support following primary extubation in infants below 30 weeks gestation when given at equivalent mean airway pressure.
Our objective in this study is to compare the effects of n-BiPAP and N-CPAP at equal mean airway pressure on CO2 elimination, thus reflecting minute ventilation in the 1st 48 hours following extubation. We plan to carry out a comparison of the documented blood gases collected as part of routine clinical care for infants during the time they were randomised in the EXTUBATE trial. This will allow a comparison of PCO2 levels between comparable groups of infants receiving either Biphasic or flat CPAP at equivalent mean airway pressure.REC name
North West - Haydock Research Ethics Committee
REC reference
17/NW/0210
Date of REC Opinion
12 Apr 2017
REC opinion
Favourable Opinion