High vs Low CPAP Strategy with Aerosolized Calfactant in Preterm Infants with Respiratory Distress Syndrome

Abstract

Abstract Background. CPAP levels used for respiratory distress syndrome are variable. Optimal CPAP strategy to prevent CPAP failure 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. Comparisons were made between low and high CPAP groups (Low, 4-7 cm H20; High, 8-10 cm H20). Results. Low and high CPAP groups had 215 and 106 infants respectively. CPAP failure and pneumothorax were not different between the groups. Odds of CPAP failure was 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 less invasive surfactant treatment needs to be evaluated in future studies.