Comparison of sprinting vs non-sprinting to wean nasal continuous positive airway pressure off in very preterm infants

Objective:though nasal continuous positive airway pressure (ncpap) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning ncpap is not established. in this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off ncpap increases successful weaning from ncpap in infants born <31 weeks gestational age.study design:infants were randomized to one of the two ncpap weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off cpap, protocol vs a non-sprinting (weaning pressure down) protocol.result:eighty-six infants were enrolled in one of the two study groups. thirty-one infants (77%) in the sprinting group and 30 (75%) in the non-sprinting group were successfully weaned off ncpap at the first attempt (p>0.05). it took 1.3 (1 to 1.75) (median (iqr)) attempts and 7 (7 to 7) days to wean ncpap off in the sprinting group vs 1.3 (1 to 1.75) attempts and 7 (7 to 10) days in the non-sprinting group (p>0.05). additionally, no differences in the secondary outcomes of bronchopulmonary dysplasia, severe retinopathy of prematurity (⩾stage 3), periventricular leukomalacia and length of stay were noted between the two groups.conclusion:weaning ncpap via sprinting or non-sprinting protocol is comparable, not only for successful weaning but also for the occurrence of common neonatal morbidities that impact the long-term outcome in premature infants (clinicaltrials.gov number, nct02819050).