Affiliations: [a]
Neonatal Intensive Care Unit; Kovai Medical Center and Hospital (KMCH), Coimbatore, India
| [b]
KMCH Research Foundation, Coimbatore, India
Correspondence:
[*]
Address for correspondences: Dr Srinivas Ramakrishnan, Consultant and Head, Neonatal intensive care unit, Kovai Medical Center and Hospital (KMCH), Coimbatore 641014, India. Tel.: +91 9487217694; E-mail: drsrinivas@kmchhospitals.com.
Abstract: BACKGROUND:There is no objective criteria to wean CPAP in preterm neonates. We aimed to assess the accuracy of ‘saturation trends’ to predict successful CPAP discontinuation. METHODS:We included very preterm neonates who required CPAP. Index tests were ‘saturation trends’. Outcome was successful CPAP discontinuation, defined as baby stable in room air for 72 h. RESULTS:We had 120 neonates with mean±SD gestation 28.6±1.8 weeks. 96 (80%) neonates had successful discontinuation and 24 (20%) failed. Neonates with successful discontinuation had significantly greater ‘saturation trends’ during 24 h before discontinuing CPAP compared to those who failed [64.3 (48.1–83.7) vs. 47.3 (23.0–65.0), p = 0.001]. Saturations > 95% while on CPAP with 21% FiO2 for > 60% time had 63% sensitivity and 70% specificity to predict successful CPAP discontinuation. CONCLUSION:‘Saturation trends’ is a readily available objective parameter that can be used to guide weaning CPAP in preterm neonates.
