Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
European Journal of Pediatrics
Erschienen in: European Journal of Pediatrics 10/2012

01.10.2012 | Review

CPAP review

verfasst von: Olie Chowdhury, Catherine J. Wedderburn, Donovan Duffy, Anne Greenough

Erschienen in: European Journal of Pediatrics | Ausgabe 10/2012

Einloggen, um Zugang zu erhalten

Abstract

Continuous positive airway pressure (CPAP) is widely used in neonatal units both as a primary mode of respiratory support and following extubation from mechanical ventilation. In this review, the evidence for CPAP use particularly in prematurely born infants is considered. Studies comparing methods of CPAP generation have yielded conflicting results, but meta-analysis of randomised trials has demonstrated that delivering CPAP via short nasal prongs is most effective in preventing re-intubation. At present, there is insufficient evidence to establish the safety or efficacy of high flow nasal cannulae for prematurely born infants. Observational studies highlighted that early CPAP use rather than intubation and ventilation was associated with a lower incidence of bronchopulmonary dysplasia (BPD), but this has not been confirmed in three large randomised trials. Meta-analysis of the results of randomised trials has demonstrated that use of CPAP reduces extubation failure, particularly if a CPAP level of 5 cm H2O or more is used. Nasal injury can occur and is related to the length of time CPAP is used; weaning CPAP by pressure rather than by “time-cycling” reduces the weaning time and may reduce BPD. In conclusion, further studies are required to identify the optimum mode of CPAP generation and it is important that prematurely born infants are weaned from CPAP as soon as possible.
Literatur
1.
Aly H, Massaro AN, Patel K, El-Mohandes AA (2005) Is it safer to intubate premature infants in the delivery room? Pediatrics 115:1660–1665PubMedCrossRef
2.
Aly H, Milner JD, Patel K, El-Mohandes AA (2004) Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants? Pediatrics 114:697–702PubMedCrossRef
3.
Ammari A, Suri M, Milisavljevic V, Sahni R, Bateman D, Sanocka U, Ruzal-Shapiro C, Wung JT, Polin RA (2005) Variables associated with the early failure of nasal CPAP in very low birth weight infants. J Pediatr 147:341–347PubMedCrossRef
4.
Andréasson B, Lindroth M, Svenningsen NW, Jonson B (1988) Effects on respiration of CPAP immediately after extubation in the very preterm infant. Pediatr Pulmonol 4:213–218PubMedCrossRef
5.
Annibale DJ, Hulsey TC, Engstrom PC, Wallin LA, Ohning BL (1994) Randomized, controlled trial of nasopharyngeal continuous positive airway pressure in the extubation of very low birth weight infants. J Pediatr 124:455–460PubMedCrossRef
6.
Avery ME, Tooley WH, Keller JB, Hurd SS, Bryan MH, Cotton RB, Epstein MF, Fitzhardinge PM, Hansen CB, Hansen TN et al (1987) Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics 79:26–30PubMed
7.
Birenbaum HJ, Dentry A, Cirelli J, Helou S, Pane MA, Starr K, Melick CF, Updegraff L, Arnold C, Tamayo A, Torres V, Gungon N, Liverman S (2009) Reduction in the incidence of chronic lung disease in very low birth weight infants: results of a quality improvement process in a tertiary level neonatal intensive care unit. Pediatrics 123:44–50PubMedCrossRef
8.
Bowe L, Clarke P (2005) Current use of nasal continuous positive airways pressure in neonates. Arch Dis Child Fetal Neonatal Ed 90:F92–F93PubMedCrossRef
9.
Campbell DM, Shah PS, Shah V, Kelly EN (2006) Nasal continuous positive airway pressure from high flow cannula versus infant flow for preterm infants. J Perinatol 26:546–549PubMedCrossRef
10.
Chan V, Greenough A (1993) Randomised trial of methods of extubation in acute and chronic respiratory distress. Arch Dis Child 68:570–572PubMedCrossRef
11.
Courtney SE, Kahn DJ, Singh R, Habib RH (2011) Bubble and ventilator-derived nasal continuous positive airway pressure in premature infants: work of breathing and gas exchange. J Perinatol 31:44–50PubMedCrossRef
12.
Dani C, Bertini G, Pezzati M, Cecchi A, Caviglioli C, Rubaltelli FF (2004) Early extubation and nasal continuous positive airway pressure after surfactant treatment for respiratory distress syndrome among preterm infants <30 weeks’ gestation. Pediatrics 113:e560–e563PubMedCrossRef
13.
Davis P, Jankov R, Doyle L, Henschke P (1998) Randomised, controlled trial of nasal continuous positive airway pressure in the extubation of infants weighing 600 to 1250 g. Arch Dis Child Fetal Neonatal Ed 79:F54–F57PubMedCrossRef
14.
Davis PG, Henderson-Smart DJ (2003) Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants. Cochrane Database Syst Rev 2:CD000143PubMed
15.
De Klerk AM, De Klerk RK (2001) Nasal continuous positive airway pressure and outcomes of preterm infants. J Paediatr Child Health 37:161–167PubMedCrossRef
16.
De Paoli AG, Davis PG, Faber B, Morley CJ (2008) Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates. Cochrane Database Syst Rev 1:CD002977PubMed
17.
Dimitriou G, Greenough A, Kavvadia V, Laubscher B, Alexiou C, Pavlou V, Mantagos S (2000) Elective use of nasal continuous positive airways pressure following extubation of preterm infants. Eur J Pediatr 159:434–439PubMedCrossRef
18.
Engelke SC, Roloff DW, Kuhns LR (1982) Postextubation nasal continuous positive airway pressure. A prospective controlled study. Am J Dis Child 136:359–361PubMed
19.
Frey B, McQuillan PJ, Shann F, Freezer N (2001) Nasopharyngeal oxygen therapy produces positive end-expiratory pressure in infants. Eur J Pediatr 160:556–560PubMedCrossRef
20.
Gittermann MK, Fusch C, Gittermann AR, Regazzoni BM, Moessinger AC (1997) Early nasal continuous positive airway pressure treatment reduces the need for intubation in very low birth weight infants. Eur J Pediatr 156:384–388PubMedCrossRef
21.
Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK (1971) Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. N Engl J Med 284:1333–1340PubMedCrossRef
22.
Gupta S, Sinha SK, Tin W, Donn SM (2009) A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome. J Pediatr 154:645–650PubMedCrossRef
23.
Harrison VC, Heese Hde V, Klein M (1968) The significance of grunting in hyaline membrane disease. Pediatrics 41:549–559PubMed
24.
Higgins RD, Richter SE, Davis JM (1991) Nasal continuous positive airway pressure facilitates extubation of very low birth weight neonates. Pediatrics 88:999–1003PubMed
25.
Huckstadt T, Foitzik B, Wauer RR, Schmalisch G (2003) Comparison of two different CPAP systems by tidal breathing parameters. Intensive Care Med 29:1134–1140PubMedCrossRef
26.
Jacobsen T, Grønvall J, Petersen S, Andersen GE (1993) “Minitouch” treatment of very low-birth-weight infants. Acta Paediatr 82:934–938PubMedCrossRef
27.
Jaile JC, Levin T, Wung JT, Abramson SJ, Ruzal-Shapiro C, Berdon WE (1992) Benign gaseous distension of the bowel in premature infants treated with nasal continuous airway pressure: a study of contributing factors. AJR Am J Roentgenol 158:125–127PubMed
28.
Jardine L, Davies MW (2008) Withdrawal of neonatal continuous positive airway pressure: current practice in Australia. Pediatr Int 50:572–575PubMedCrossRef
29.
Kavvadia V, Greenough A, Dimitriou G (2000) Effect on lung function of continuous positive airway pressure administered either by infant flow driver or a single nasal prong. Eur J Pediatr 159:289–292PubMedCrossRef
30.
Kieran EA, Walsh H, O’Donnell CP (2011) Survey of nasal continuous positive airways pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) use in Irish newborn nurseries. Arch Dis Child Fetal Neonatal Ed 96:F156PubMedCrossRef
31.
Klausner JF, Lee AY, Hutchison AA (1996) Decreased imposed work with a new nasal continuous positive airway pressure device. Pediatr Pulmonol 22:188–194PubMedCrossRef
32.
Lee KS, Dunn MS, Fenwick M, Shennan AT (1998) A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation. Biol Neonate 73:69–75PubMedCrossRef
33.
Lindner W, Vossbeck S, Hummler H, Pohlandt F (1999) Delivery room management of extremely low birth weight infants: spontaneous breathing or intubation? Pediatrics 103:961–967PubMedCrossRef
34.
Liptsen E, Aghai ZH, Pyon KH, Saslow JG, Nakhla T, Long J, Steele AM, Habib RH, Courtney SE (2005) Work of breathing during nasal continuous positive airway pressure in preterm infants: a comparison of bubble vs variable-flow devices. J Perinatol 25:453–458PubMedCrossRef
35.
Locke R, Greenspan JS, Shaffer TH, Rubenstein SD, Wolfson MR (1991) Effect of nasal CPAP on thoracoabdominal motion in neonates with respiratory insufficiency. Pediatr Pulmonol 11:259–264PubMedCrossRef
36.
Miksch RM, Armbrust S, Pahnke J, Fusch C (2008) Outcome of very low birthweight infants after introducing a new standard regime with the early use of nasal CPAP. Eur J Pediatr 167:909–916PubMedCrossRef
37.
Miller MJ, Carlo WA, Martin RJ (1985) Continuous positive airway pressure selectively reduces obstructive apnea in preterm infants. J Pediatr 106(1):91–94PubMedCrossRef
38.
Miller MJ, DiFiore JM, Strohl KP, Martin RJ (1990) Effects of nasal CPAP on supraglottic and total pulmonary resistance in preterm infants. J Appl Physiol 68:141–146PubMed
39.
Miller SM, Dowd SA (2010) High-flow nasal cannula and extubation success in the premature infant: a comparison of two modalities. J Perinatol 30:805–808PubMedCrossRef
40.
Moa G, Nilsson K, Zetterström H, Jonsson LO (1988) A new device for administration of nasal continuous positive airway pressure in the newborn: an experimental study. Crit Care Med 16:1238–1242PubMedCrossRef
41.
Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB, Trial Investigators COIN (2008) Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 358:700–708PubMedCrossRef
42.
Nair G, Karna P (2005) Comparison of the effects of vapotherm and nasal CPAP in respiratory distress. PAS.1.
43.
Narendran V, Morley CJ, Lau R, De Paoli A, Davis PG (2003) Early bubble CPAP and outcomes in ELBW preterm infants. J Perinatol 23:195–199PubMedCrossRef
44.
Pandit PB, Morley CJ, Lau R, De Paoli A, Davis PG (2001) Work of breathing during constant- and variable-flow nasal continuous positive airway pressure in preterm neonates. Pediatrics 108:682–685PubMedCrossRef
45.
Pantalitschka T, Sievers J, Urschitz MS, Herberts T, Reher C, Poets CF (2009) Randomised crossover trial of four nasal respiratory support systems for apnoea of prematurity in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 94:F245–F248PubMedCrossRef
46.
Peake M, Dillon P, Shaw NJ (2005) Randomized trial of continuous positive airways pressure to prevent reventilation in preterm infants. Pediatr Pulmonol 39:247–250PubMedCrossRef
47.
Richardson CP, Jung AL (1978) Effects of continuous positive airway pressure on pulmonary function and blood gases of infants with respiratory distress syndrome. Pediatr Res 12:771–774PubMedCrossRef
48.
Robertson NJ, McCarthy LS, Hamilton PA, Moss AL (1996) Nasal deformities resulting from flow driver continuous positive airway pressure. Arch Dis Child Fetal Neonatal Ed 75:F209–F212PubMedCrossRef
49.
Sandri F, Ancora G, Lanzoni A, Tagliabue P, Colnaghi M, Ventura ML, Rinaldi M, Mondello I, Gancia P, Salvioli GP, Orzalesi M, Mosca F (2004) Prophylactic nasal continuous positive airways pressure in newborns of 28–31 weeks gestation: multicentre randomised controlled clinical trial. Arch Dis Child Fetal Neonatal Ed 89:F394–F398PubMedCrossRef
50.
Sandri F, Plavka R, Ancora G, Simeoni U, Stranak Z, Martinelli S, Mosca F, Nona J, Thomson M, Verder H, Fabbri L, Halliday H, CURPAP Study Group (2010) Prophylactic or early selective surfactant combined with nCPAP in very preterm infants. Pediatrics 125:e1402–e1409PubMedCrossRef
51.
Singh SD, Clarke P, Bowe L, Glover K, Pasquill A, Robinson MJ, Smith J (2006) Is decreasing pressure or increasing time off the better strategy in weaning VLBW infants from nasal CPAP. European Journal of Pediatrics, Book of Abstracts European Academy of Pediatrics 165:48
52.
So BH, Tamura M, Mishina J, Watanabe T, Kamoshita S (1995) Application of nasal continuous positive airway pressure to early extubation in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 72:F191–F193PubMedCrossRef
53.
Soe A, Hodgkinson J, Jani B, Ducker DA (2006) Nasal continuous positive airway pressure weaning in preterm infants. European Journal of Paediatrics, Book of Abstracts European Academy of Paediatrics 165:48–49
54.
Stefanescu BM, Murphy WP, Hansell BJ, Fuloria M, Morgan TM, Aschner JL (2003) A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants. Pediatrics 112:1031–1038PubMedCrossRef
55.
SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network (2010) Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 362:1970–1979CrossRef
56.
Tapia JL, Bancalari A, González A, Mercado ME (1995) Does continuous positive airway pressure (CPAP) during weaning from intermittent mandatory ventilation in very low birth weight infants have risks or benefits? A controlled trial. Pediatr Pulmonol 19:269–274PubMedCrossRef
57.
Todd D, Shadbolt B, Wright A, Chauhan M, Cameron C, Jardine L et al (2010) CPAP Weaning: impact on time of CPAP and oxygen duration? In: Abstracts of the 14th Annual Congress of the Perinatal Society of Australia and New Zealand 28–31 March 2010, Wellington, New Zealand. J Paediatr Child Health 46:A143
58.
Trevisanuto D, Camiletti L, Doglioni N, Cavallin F, Udilano A, Zanardo V (2011) Noise exposure is increased with neonatal helmet CPAP in comparison with conventional nasal CPAP. Acta Anaesthesiol Scand 55:35–38PubMedCrossRef
59.
Trevisanuto D, Grazzina N, Doglioni N, Ferrarese P, Marzari F, Zanardo V (2005) A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system. Intensive Care Med 31:859–864PubMedCrossRef
60.
Van Marter LJ, Allred EN, Pagano M, Sanocka U, Parad R, Moore M, Susser M, Paneth N, Leviton A (2000) Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease? The Neonatology Committee for the Developmental Network. Pediatrics 105:1194–1201PubMedCrossRef
61.
Wilkinson D, Andersen C, O’Donnell CP, De Paoli AG (2011) High flow nasal cannula for respiratory support in preterm infants. Cochrane Database Syst Rev 5:CD006405PubMed
62.
Woodhead DD, Lambert DK, Clark JM, Christensen RD (2006) Comparing two methods of delivering high-flow gas therapy by nasal cannula following endotracheal extubation: a prospective, randomized, masked, crossover trial. J Perinatol 26:481–485PubMedCrossRef
63.
Yong SC, Chen SJ, Boo NY (2005) Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants: a randomised control study. Arch Dis Child Fetal Neonatal Ed 90:F480–F483PubMedCrossRef
64.
Zaramella P, Freato F, Grazzina N, Saraceni E, Vianello A, Chiandetti L (2006) Does helmet CPAP reduce cerebral blood flow and volume by comparison with Infant Flow driver CPAP in preterm neonates? Intensive Care Med 32:1613–1619PubMedCrossRef
Metadaten
Titel
CPAP review
verfasst von
Olie Chowdhury
Catherine J. Wedderburn
Donovan Duffy
Anne Greenough
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
European Journal of Pediatrics / Ausgabe 10/2012
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-011-1648-6

Weitere Artikel der Ausgabe 10/2012

European Journal of Pediatrics 10/2012 Zur Ausgabe

Original Paper

The influence of migratory background and parental education on health care utilisation of children

Original Paper

Targeted fluconazole prophylaxis for high-risk very low birth weight infants

Original Paper

The diagnostic value of a single measurement of superior vena cava flow in the first 24 h of life in very preterm infants

Original Paper

Griscelli syndrome types 1 and 3: analysis of four new cases and long-term evaluation of previously diagnosed patients

Case Report

Medical management of moyamoya disease and recurrent stroke in an infant with Majewski osteodysplastic primordial dwarfism type II (MOPD II)

Original Paper

Reduced cardiac output and its correlation with coronary blood flow and troponin in asphyxiated infants treated with therapeutic hypothermia

Neu im Fachgebiet Pädiatrie

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

Frühe Hypertonie erhöht späteres kardiovaskuläres Risiko

16.05.2024 Arterielle Hypertonie in der Pädiatrie Nachrichten

Wie wichtig es ist, pädiatrische Patienten auf Bluthochdruck zu screenen, zeigt eine kanadische Studie: Hypertone Druckwerte in Kindheit und Jugend steigern das Risiko für spätere kardiovaskuläre Komplikationen.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise