Utility of saturation trends to predict successful weaning of nasal CPAP in very preterm neonates – A prospective study

Abstract

BACKGROUND:

There is no objective criteria to wean CPAP in preterm neonates. We aimed to assess the accuracy of ‘saturation trends’ to predict successful CPAP discontinuation.

METHODS:

We included very preterm neonates who required CPAP. Index tests were ‘saturation trends’. Outcome was successful CPAP discontinuation, defined as baby stable in room air for 72 h.

RESULTS:

We had 120 neonates with mean±SD gestation 28.6±1.8 weeks. 96 (80%) neonates had successful discontinuation and 24 (20%) failed. Neonates with successful discontinuation had significantly greater ‘saturation trends’ during 24 h before discontinuing CPAP compared to those who failed [64.3 (48.1–83.7) vs. 47.3 (23.0–65.0), p = 0.001]. Saturations > 95% while on CPAP with 21% FiO₂ for > 60% time had 63% sensitivity and 70% specificity to predict successful CPAP discontinuation.

CONCLUSION:

‘Saturation trends’ is a readily available objective parameter that can be used to guide weaning CPAP in preterm neonates.