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This study aimed to determine the efficacy of different NCPAP weaning strategies in pre-term infants presenting with respiratory distress, and ultimately establishing the best method to withdraw from NCPAP.
Pakistan, as well as other developing countries, lacks data regarding the weaning protocol of NCPAP. Ascertaining the best weaning method that could facilitate a shorter duration on nasal CPAP and the least length of hospital stay is very much needed. Findings of this study would help clinicians to achieve better outcomes for the patients receiving nasal CPAP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sudden weaning of NCPAP | Experimental | NCPAP was taken "off" entirely when the neonate met the "stability criteria" and remained on oxygen or room air via a headbox or incubator with an aim to stay off NCPAP. |
|
| Gradual Weaning with increasing the time off NCPAP | Experimental | The regimen adopted for this method was 1 hour off twice a day on the 1st day, then 2 hours off twice a day on the 2nd day, hence increasing the time off to 6 hours twice a day (or 12 hours per day), i.e., using a smaller period off. At this point, NCPAP was taken off completely. |
|
| Pressure weaning of NCPAP | Experimental | In this method the pressure was reduced in steps of 1 cm of H2O every 12 to 24 hours until 5 cm of H2O, and then if the child tolerated it well, NCPAP was removed, and the child was shifted to oxygen via incubator or room air according to the situation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sudden weaning of NCPAP | Procedure | NCPAP was taken "off" entirely when the neonate met the "stability criteria" and remained on oxygen or room air via a headbox or incubator with an aim to stay off NCPAP. |
| Measure | Description | Time Frame |
|---|---|---|
| Successful weaning | Weaning was considered as successful in the absence of pronounced retractions, tachypnea, or episodes of apnea and if there was no requirement for ventilator support after cessation of NCPAP support. | 4 days |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of total days on NCPAP | Total days on NCPAP for the three weaning strategies were measured from the start of NCPAP to the removal of NCPAP | 4 days |
| Hospital stay | Total days of hospital stay were measured from the admission to discharge from the hospital. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rabia Asif | Ziauddin University Karachi | Principal Investigator |
| Heena Rais, FCPS | Ziauddin University Karachi | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ziauddin University | Karachi | Sindh | 75600 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42291608 | Derived | Asif R, Rais H, Anwar T, Safdar S. Comparison of methods of Weaning from Nasal Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial. Pak J Med Sci. 2026 May;42(5):1243-1249. doi: 10.12669/pjms.42.5.15003. |
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Data can be shared on a reasonable request.
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| Gradual weaning with increasing the time off NCPAP | Procedure | The regimen adopted for this method was 1 hour off twice a day on the 1st day, then 2 hours off twice a day on the 2nd day, hence increasing the time off to 6 hours twice a day (or 12 hours per day), i.e., using a smaller period off. At this point, NCPAP was taken off completely. |
|
| Pressure weaning of NCPAP | Procedure | In this method the pressure was reduced in steps of 1 cm of H2O every 12 to 24 hours until 5 cm of H2O, and then if the child tolerated it well, NCPAP was removed, and the child was shifted to oxygen via incubator or room air according to the situation. |
|
| 25 days |
| ID | Term |
|---|---|
| D012127 | Respiratory Distress Syndrome, Newborn |
| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D007235 | Infant, Premature, Diseases |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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