Continued Pressure for Alveolar Protection (CPAP Trial)

Continued Pressure for Alveolar Protection: A Randomized Controlled Trial (CPAP Trial)

The objective of the CPAP Trial is to test whether extending CPAP until 34 weeks' PMA or for at least 2 additional weeks compared to weaning to a nasal canula will decrease the likelihood of bronchopulmonary dysplasia or death at 36 weeks' PMA.

Inclusion Criteria:

• Gestational age <29 weeks at birth
• PMA <32 weeks at study entry
• On treatment with CPAP without a rate in FiO2 <0.25 and PEEP of 4-5 cmH2O
• Meet stability criteria:
• If previously intubated must be extubated ≥ 72 hours
• <3 self-resolving apneas (≤ 20 s) and/or bradycardia (<100 bpm) in any hour over previous 6 hours
• No episodes of apnea or bradycardia requiring intervention (oxygen/stimulation/bag and mask) for 24 hours
• Parents/legal guardians consent for enrollment

Exclusion Criteria:

• Major malformation
• Neuromuscular condition that affects respiration
• Terminal illness
• Decision to withhold or limit support
• Too sick to participate in opinion of Attending physician
• Clinical shock, sepsis
• Planned surgery during study period