Strategies to wean off nasal CPAP

A pilot randomized study compared four methods of weaning a baby off nasal CPAP – abruptly taking a baby off CPAP and placing on high-flow nasal cannula at 6 lpm (Group 1); abruptly taking a baby off CPAP to either room air or low-flow nasal cannula (Group 2); gradual weaning off CPAP by placing on increasing duration on HFNC alternating with CPAP (Group 3); and gradual wean off CPAP without use of HFNC (Group 4 – babies were placed in room air or low-flow cannula when not on CPAP). The primary outcomes of┬áduration of respiratory support, chronic lung disease, length of hospital stay and time to full suck feeds were not different between the four groups, although the study was underpowered (a total of 60 patients). More parents in group 2 withdrew their infants from the study than in other groups. Group 1┬áhad the shortest duration of nasal CPAP.

Weaning strategies for preterm infants on CPAP. Tang et al, 2015.