Utility of saturation trends to predict successful weaning of nasal CPAP in very preterm neonates - A prospective study.

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.