High vs low CPAP strategy with aerosolized calfactant in preterm infants with respiratory distress syndrome

D C Kaluarachchi; E Gerday; T Bahr; H A Zapata; M R Lasarev; S O Guthrie; S Minton

doi:10.1038/s41372-024-01959-7

High vs low CPAP strategy with aerosolized calfactant in preterm infants with respiratory distress syndrome

J Perinatol. 2024 Apr 9. doi: 10.1038/s41372-024-01959-7. Online ahead of print.

Authors

D C Kaluarachchi¹, E Gerday², T Bahr², H A Zapata³, M R Lasarev⁴, S O Guthrie^{5

6}, S Minton²

Affiliations

¹ Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA. kaluarachchi@pediatrics.wisc.edu.
² Utah Valley Hospital, Provo, UT and Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
³ Department of Pediatrics, Division of Neonatology, University of Florida School of Medicine -Jacksonville, Jacksonville, FL, USA.
⁴ Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA.
⁵ Department of Pediatrics, Division of Neonatology, Vanderbilt University School of Medicine, Nashville, TN, USA.
⁶ Jackson-Madison County General Hospital, Jackson, TN, USA.

PMID: 38594414
DOI: 10.1038/s41372-024-01959-7

Abstract

Background: Optimal CPAP strategy to prevent CPAP failure defined as need for endotracheal intubation is unknown.

Objective: To evaluate the risk of CPAP failure in infants treated with high vs low CPAP strategy while receiving aerosolized calfactant in the AERO-02 clinical trial and AERO-03 expanded access program.

Methods: Infants born between 29 0/7 to 36 6/7 weeks were included. Comparisons were made between low and high CPAP groups (Low, 4-7 cm H₂O; High, 8-10 cm H₂O).

Results: CPAP failure and pneumothorax were not different between the groups. Odds of CPAP failure were not different after adjustment for baseline characteristics (OR = 0.61; 95% CI: 0.29, 1.24).

Conclusion: We found no difference in CPAP failure among infants who received aerosolized calfactant that were treated with high vs low CPAP strategy. Efficacy of high CPAP strategy with aerosolized surfactant treatment needs to be evaluated in future studies.