Comparing Continued CPAP Use Versus Nasal Cannula to Prevent Lung Problems or Death in Premature Infants

What this Trial Is About

Researchers are evaluating whether continuing Continuous Positive Airway Pressure CPAP therapy until 34 weeks postmenstrual age PMA or for at least two additional weeks can reduce the risk of bronchopulmonary dysplasia BPD or death by 36 weeks PMA in premature infants. The study compares extended CPAP use to weaning infants to a nasal cannula, aiming to find the best respiratory support approach for this vulnerable population. The trial involves two groups one receiving CPAP via mask or binasal prongs, with bubble CPAP preferred when available, and the other using high-flow nasal cannula HFNC starting at 4 Lmin, adjusted daily based on breathing criteria. Infants in the nasal cannula group who meet certain failure criteria may have their flow increased or be placed back on CPAP with provider-chosen interfaces. The study is randomized and parallel in design, focusing on prevention of lung problems or death. Participants are monitored for lung health outcomes at various times, including the primary outcome of bronchopulmonary dysplasia or death at 36 weeks PMA. Secondary outcomes include days alive without respiratory support, mortality rates, retinopathy of prematurity, respiratory support needs, feeding milestones, and length of hospitalization up to 52 weeks PMA. The study is sponsored by the NICHD Neonatal Research Network and runs from November 2026 to January 2029, with regular assessments to evaluate respiratory status and overall health.

Continued Pressure for Alveolar Protection (CPAP Trial)