SURFACTANT POSITIVE AIRWAY PRESSURE AND PULSE OXIMETRY TRIAL (SUPPORT)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. At the present time there is no recommendation or standard teaching regarding the early use of CPAP/PEEP during resuscitation and continuing after NICU admission for the extremely low birth weight (ELBW) infant. However, a number of studies, mostly retrospective in nature, have suggested that the use of early CPAP may be associated with improved outcomes, including a decreased need for mechanical ventilation, a decreased need for surfactant therapy, and a decrease in oxygen supplementation and/or death at 28 days after birth and at 36 weeks post menstrual age. There has not been a prospective study which has randomized ELBW infants to CPAP/PEEP beginning in the delivery room, and continuing in the NICU and a permissive ventilation strategy if intubation is required and compared their outcomes to infants treated with prophylactic or early natural surfactant, interventions with known efficacy in reducing mortality, severity of disease and the incidence of chronic lung disease.