Signs of CPAP failure after birth

An observational study from one center used the results of pulmonary function testing in 32 preterm infants stabilized on CPAP immediately after birth to compare patterns in infants who failed CPAP versus those who succeeded. Respiratory interventions were recorded starting from birth using a webcam and a respiratory function monitor, with a hot wire anemometer as a flow sensor between the T-piece and facemask (dead space <1 ml) to detect gas flow in and out of the mask. Around ten minutes of life, infants who failed CPAP had a higher frequency of smaller tidal-volume breaths, higher peak inspiratory flows, higher FiO2, higher CPAP pressures, and more positive-pressure breaths. The tidal volume was less variable and larger tidal volume was infrequently used, reflecting early signs of fatigue

Very preterm infants failing CPAP show signs of fatigue immediately after birth. Siew et al, 2015