Infant flow biphasic nasal continuous positive airway pressure (BP- NCPAP) vs. infant flow NCPAP for the facilitation of extubation in infants [less than or equal to] 1,250 grams: A randomized controlled trial

BMC Pediatrics, 04/18/2012

O'Brien K et al. – Biphasic NCPAP may be used to assist in weaning from mechanical ventilation. The effectiveness and safety of biphasic nasal continuous positive airway pressure (BP–NCPAP) compared to NCPAP needs to be confirmed in a large multi–center trial as study conclusions are limited by inadequate sample size.


  • The authors performed a randomized controlled trial of BP-NCPAP vs. NCPAP in infants < 1,250 grams extubated for the first time following mechanical ventilation since birth.
  • Infants were extubated using preset criteria or at the discretion of the attending neonatologist.
  • The primary outcome was the incidence of sustained extubation for 7 days.
  • Secondary outcomes included incidence of adverse events and short-term neonatal outcomes.


  • Sixty-seven infants received BP-NCPAP and 69 NCPAP.
  • Baseline characteristics were similar between groups.
  • The trial was stopped early due to increased use of non-invasive ventilation from birth, falling short of calculated sample size of 141 infants per group.
  • The incidence of sustained extubation was not statistically different between the BP-NCPAP vs. NCPAP group (67% vs. 58%, P = 0.27).
  • The incidence of adverse events and short-term neonatal outcomes were similar between the two groups (P > 0.05) except for retinopathy of prematurity which was noted to be higher (P = 0.02) in the BP-NCPAP group.

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