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International Journal of Pediatrics
Volume 2012, Article ID 416073, 7 pages
http://dx.doi.org/10.1155/2012/416073
Research Article

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

1Division of Neonatology, Maimonides Infants Children Hospital of Brooklyn, 1048 Tenth Avenue, G-103, Brooklyn, NY 11203, USA
2SUNY Health Science Center at Brooklyn, NY 11203-2098, USA
3Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY 10467, USA
4Division of Neonatology, Morgan Stanley Children's Hospital of New York, College of Physicians and Surgeons, Columbia University, Broadway, NY 10032, USA

Received 3 August 2011; Revised 21 September 2011; Accepted 28 September 2011

Academic Editor: Mei-Jy Jeng

Copyright © 2012 Shantanu Rastogi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Identification of the weight and postmenstrual age (PMA) at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean. Study Design. Retrospective review of 454 neonates ≤32 weeks of gestational age (GA) who were placed on NCPAP and successfully weaned to room air was performed. Results. Neonates had a mean birth weight (BW) of 1 3 5 7 ± 3 9 2 grams with a mean GA of 2 9 . 3 ± 2 . 2 weeks. Neonates were weaned off NCPAP at mean weight of 1 6 1 1 ± 4 3 2 grams and mean PMA of 3 2 . 9 ± 2 . 4 weeks. Univariate analysis showed that chorioamnionitis, intubation, surfactant use, PDA, sepsis/NEC, anemia, apnea, GER and IVH were significantly associated with the time to NCPAP wean. On multivariate analysis, among neonates that were intubated, BW was the only significant factor ( 𝑃 < 0 . 0 0 1 ) that was inversely related to time to successful NCPAP wean. Amongst non-intubated neonates, along with BW ( 𝑃 < 0 . 0 1 ), chorioamnionitis ( 𝑃 < 0 . 0 1 ), anemia ( 𝑃 < 0 . 0 0 0 1 ), and GER ( 𝑃 < 0 . 0 2 ) played a significant role in weaning from NCPAP. Conclusion. Neonates were weaned off NCPAP at mean weight of 1 6 1 1 ± 4 3 2 grams and mean PMA of 3 2 . 9 ± 2 . 4 weeks. BW significantly affects weaning among intubated and non-intubated neonates, though in neonates who were never intubated chorioamnionitis, anemia and GER also significantly affected the duration on NCPAP.