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CeasIng Cpap At standarD criteriA (CICADA): predicting a successful outcome

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Abstract

This is a retrospective analysis of a multicentre randomised controlled trial (RCT) where we concluded that CeasIng Cpap At standerD criteriA (CICADA) in premature babies (PBs) <30 weeks gestational age (GA) was the significantly better method of ceasing CPAP. To identify factors that may influence the number of attempts to cease CPAP, we reviewed the records of 50 PBs from the RCT who used the CICADA method. PBs were grouped according to number of attempts to cease CPAP (fast group ≤2 attempts and slow group >2 attempts to cease CPAP). There were 26 (fast group) and 24 (slow group) PBs included in the analysis. Results showed significant differences in mean GA (27.8 ± 0.3 vs 26.9 ± 0.3 [weeks ± SE], p = 0.03) and birth weight ([Bwt]; 1080 ± 48.8 vs 899 ± 45.8 [grams ± SE], p = 0.01) between groups. Significantly fewer PBs in the fast group had a patent ductus arteriosus (PDA) compared to the slow group (5/26 (19.2 %) vs 13/24 (54.2 %), p = 0.02). Bwt was a significant negative predictor of CPAP duration (r = −0.497, p = 0.03) and CPAP ceasing attempts (r = −0.290, p = 0.04).

Conclusion: PBs with a higher GA and Bwt without a PDA ceased CPAP earlier using the CICADA method. Bwt was better than GA for predicting CPAP duration and attempts to cease CPAP.

What is Known:

• Our previous studies showed that CeasIng Cpap At standarD criteriA (CICADA) significantly reduces CPAP time, oxygen requirements and caffeine use.

• Some PBs however using the CICADA method required >2 attempts to cease CPAP (‘slow CICADA’ group).

What is New:

• PBs in the ‘fast CICADA’ group (<3 attempts to cease CPAP) (a) have longer gestational age and higher birth weight, (b) shorter mechanical ventilation and (c) lower incidence of patent ductus arteriosus.

• Attempts to cease CPAP decreased by 0.5 times per 1 week increase in GA and 0.3 times per 100-g increase in birth weight for PBs <30 weeks gestation.

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Abbreviations

Bwt:

Birthweight

CICADA:

CeasIng Cpap At standarD criteriA

CGA:

Corrected GA

CLD:

Chronic lung disease

CPAP:

Continuous positive airway pressure

GA:

Gestational age

IVH:

Intraventricular haemorrhage

MV:

Mechanical ventilation

PBs:

Premature babies

PDA:

Patent ductus arteriosus

RCT:

Randomised controlled trial

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Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors declare that they have no competing interests.

Authors’ contributions

Authors YY, MB and DT generated the study. YY, MB, AW and DH collecetd the data. YY, DT, MA-L and BS analysed the data; YY, MB and DT have written the manuscript. All authors have reviewed the manuscript.

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Authors and Affiliations

  1. Australian National University Medical School, Hospital Rd, Garran, ACT, 2605, Australia

    Yue Yin, Mohamed E. Abdel-Latif, Bruce Shadbolt & David A. Todd

  2. Department of Neonatology, Centenary Hospital, Garran, ACT, PO Box 11, Woden Canberra, 2606, Australia

    Margaret Broom, Mohamed E. Abdel-Latif & David A. Todd

  3. Centre for Newborn Care, Westmead Hospital, Westmead, NSW, Australia

    Audrey Wright

  4. Grantley Stable Neonatal Intensive Care Unit, Royal Brisbane and Women’s Hospital, Butterfield St, Herston, QLD, 4006, Australia

    Donna Hovey

  5. Centre for Advances in Epidemiology and IT, Canberra Hospital, Garran, ACT, Australia

    Bruce Shadbolt

Authors
  1. Yue Yin
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  2. Margaret Broom
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  3. Audrey Wright
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  4. Donna Hovey
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  5. Mohamed E. Abdel-Latif
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  6. Bruce Shadbolt
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  7. David A. Todd
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Corresponding author

Correspondence to David A. Todd.

Additional information

Communicated by Patrick Van Reempts

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Yin, Y., Broom, M., Wright, A. et al. CeasIng Cpap At standarD criteriA (CICADA): predicting a successful outcome. Eur J Pediatr 175, 81–87 (2016). https://doi.org/10.1007/s00431-015-2603-8

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  • DOI: https://doi.org/10.1007/s00431-015-2603-8

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