High vs low CPAP strategy with aerosolized calfactant in preterm infants with respiratory distress syndrome.

BACKGROUND: Optimal CPAP strategy to prevent CPAP failure defined as need for endotracheal intubation 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: Infants born between 29 0/7 to 36 6/7 weeks were included. Comparisons were made between low and high CPAP groups (Low, 4-7 cm H2 O; High, 8-10 cm H2 O).

RESULTS: CPAP failure and pneumothorax were not different between the groups. Odds of CPAP failure were 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 aerosolized surfactant treatment needs to be evaluated in future studies.