The second is that treatment usually used for adults with sleep apnea is as effective as traditional fan and surfactant therapy used to treat respiratory problems in premature babies – and may result in fewer complications. The treatment is based on a continuous positive airway pressure machine to blow air through the nostrils gently inflate the lungs prematurely.‘Until this study, CPAP therapy has shown promise in the treatment of respiratory distress in premature infants, but had never been compared to ventilator therapy, this group of patients,’ said Alan E. Guttmacher, MD, acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development , one of the institutes of NIH, which provided the infrastructure and funding for the study. ‘The study results indicate that CPAP is an effective alternative to the initial therapy for preterm fans of 24-27 weeks gestational age.’
The team will assess the children when they are 18-22 months of age, to see if differences arise between the children who took part in the arms of the study treatments.
‘Balancing the benefits of supplemental oxygen against the risk of very preterm infants has been a concern of doctors and parents for decades,’ said NHLBI Acting Director Susan B. Shurin, MD, board-certified pediatrician. ‘The results of this scale clinical study of extremely low birth weight will help inform management decisions to improve survival and reduce complications associated with respiratory problems in these vulnerable patients.’
The NICHD sponsors research on development, before and after birth, maternal health, child and family, reproductive biology and population issues and medical rehabilitation.
The study was divided into two branches that supplied the results for articles. In the first arm, each child has a 50 % chance of receiving higher levels of oxygen saturation targets and a 50 % chance of receiving lower levels. In the second arm, each child has a 50 % chance of receiving oxygen by CPAP and a 50 % chance of receiving intubation with surfactant, a viscous substance that keeps the air sacs open the lungs. Although surfactant is usually produced by the lungs, premature babies are not ready to make a first surface and suffer from severe breathing difficulties.
A second arm of the study compared with standard care and a ventilator for surfactant respiratory distress in premature infants treated with CPAP, which consists of passing the air through the nose of a baby through the peaks remained in the nostrils. The standard treatment involves placing a breathing tube in ventilated infants the trachea to provide oxygen and surfactants. It is not possible to deliver surfactant with CPAP.
The higher oxygen levels have been associated with an increased risk of retinopathy of prematurity , a disease that affects the retina. The present study was undertaken to determine if oxygen levels slightly reduced child should remain in good health and reduce their risk of ROP.nei.nih.gov/health/rop/rop.asp) is available from the National Eye Institute.
These results appear in two papers published online by the New England Journal of Medicine. The study findings were presented May 16 at the American Thoracic Society 2010 International Conference in New Orleans.
‘Surfactant and intubation together have been shown to reduce the risk of serious complications and death in premature infants,’ said Dr. Finer. ‘But the use of CPAP also increased over the past 10 or 15 years, there are no randomized studies to test and compare it with that of the surfactant. ‘
The researchers assessed the infants in the two levels of oxygen saturation in a single combined measure, known as the combined result of their survival and the probability of living ROP. No differences emerged between the groups in general terms of measurement. However, there was a significant difference when survival and the likelihood of experiencing ROP were considered separately.
The study was conducted from 20 academic medical centers participating in the NICHD Neonatal Research Network. The study also received funding from the NIH National Heart, Lung, and Blood Institute.
In addition, premature infants born at 24-25 in the studio the first week of gestation, were less likely to die if they had received CPAP only if they had received surfactant as the initial treatment of the study.
The study included 1316 children born between 24 and 27 weeks of pregnancy. A full-term pregnancy is 40 weeks. Very premature infants in the study had an average weight of less than two pounds.
Two results of a study of NIH research network to provide new information on the amount of oxygen very premature infants should receive the first day of life and the most effective ways to deliver it to them.
The first is that the higher oxygen levels improve survival of premature infants, ‘but increase the risk of a disease that can damage the retina.
‘The study shows that CPAP is an effective alternative to surfactant in preterm infants,’ said Higgins. ‘Because it is less invasive than artificial ventilation, CPAP initially appears to be an appropriate treatment for premature babies. If CPAP is unsuccessful, a child may be placed on a ventilator and given surfactant.’
It ‘important for caregivers to ask if the grandparents had hip fractures, said Lorentzon. It ‘an important piece of the puzzle when it comes to diagnosis and treatment of osteoporosis.
‘Many doctors believe that optimal levels of oxygen saturation drops to between 85 and 95 %,’ said Dr. Charles.
‘Our results provide essential data on which to base treatment decisions.’