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    Trends in use of neonatal CPAP: a population-based study.

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    Author
    Roberts, CL; Badgery-Parker, T; Algert, CS; Bowen, JR; Nassar, N
    Date
    2011-10-17
    Source Title
    BMC Pediatrics
    Publisher
    Springer Science and Business Media LLC
    University of Melbourne Author/s
    Quach, Jon; Wake, Melissa
    Affiliation
    Melbourne Graduate School of Education
    Paediatrics (RCH)
    Metadata
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    Document Type
    Journal Article
    Citations
    Roberts, C. L., Badgery-Parker, T., Algert, C. S., Bowen, J. R. & Nassar, N. (2011). Trends in use of neonatal CPAP: a population-based study.. BMC Pediatr, 11 (1), pp.89-. https://doi.org/10.1186/1471-2431-11-89.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256096
    DOI
    10.1186/1471-2431-11-89
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206424
    Abstract
    BACKGROUND: Continuous positive airway pressure (CPAP) is used widely to provide respiratory support for neonates, and is often the first treatment choice in tertiary centres. Recent trials have demonstrated that CPAP reduces need for intubation and ventilation for infants born at 25-28 weeks gestation, and at > 32 weeks, in non-tertiary hospitals, CPAP reduces need for transfer to NICU. The aim of this study was to examine recent population trends in the use of neonatal continuous positive airway pressure. METHODS: We undertook a population-based cohort study of all 696,816 liveborn neonates ≥24 weeks gestation in New South Wales (NSW) Australia, 2001-2008. Data were obtained from linked birth and hospitalizations records, including neonatal transfers. The primary outcome was CPAP without mechanical ventilation (via endotracheal intubation) between birth and discharge from the hospital system. Analyses were stratified by age ≤32 and > 32 weeks gestation. RESULTS: Neonates receiving any ventilatory support increased from 1,480 (17.9/1000) in 2001 to 2,486 (26.9/1000) in 2008, including 461 (5.6/1000) to 1,465 (15.8/1000) neonates who received CPAP alone. There was a concurrent decrease in mechanical ventilation use from 12.3 to 11.0/1000. The increase in CPAP use was greater among neonates > 32 weeks (from 3.2 to 11.8/1000) compared with neonates ≤32 weeks (from 18.1 to 32.7/1000). The proportion of CPAP > 32 weeks initiated in non-tertiary hospitals increased from 6% to 30%. CONCLUSIONS: The use of neonatal CPAP is increasing, especially > 32 weeks gestation and among non-tertiary hospitals. Recommendations are required regarding which infants should be considered for CPAP, resources necessary for a unit to offer CPAP and monitoring of longer term outcomes.

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