Consecutive study of early CPAP-application in hyaline membrane disease.

Continuous positive airways pressure (CPAP) has been applied with a face-chamber in 74 infants with hyaline membrane disease (HMD) before 10 h of age. The total survival rate was 91% and the complication rate of pneumothorax was low (5%). The incidence of long term developmental and neurological sequelae was also low (4%). Among the 19 surviving very low birth-weight (VLBW) infants below 1501 g, only one has shown neurological sequelae at follow-up examinations after 18 months to 3 years of age. The incidence of cerebellar hemorrhage was not higher in infants treated with the CPAP face chamber than in infants not receiving assisted ventilation. Bronchopulmonary dysplasia did not occur in any infant treated with CPAP face chamber only. The main advantages with the face chamber technique are: no disturbance of glottis function, no mucosal damage and tube obstruction, or sudden pressure drops, as seen with other modes of CPAP application. The face chamber technique is suitable for early application of CPAP in infants with HMD as it is efficient, without hazards, and easily applied.