Early intervention summaries:
Avoidance of mechanical ventilation by surfactant treatment of spontaneously breathing preterm infants (AMV): an open-label, randomised, controlled trial (2011)
Göpel W, Kribs A, Ziegler A, Laux R, Hoehn T, et al.
The AMV trial explored the impact of early intervention with surfactant administration via LISA for spontaneously breathing preterm infants on CPAP. This proactive approach, tested across 12 German NICUs, demonstrated that delivering surfactant early and without mechanical ventilation significantly reduced the need for later intubation, shortened ventilation times, and lowered oxygen dependency at 28 days compared with standard treatment.
These findings highlight the benefits of early, minimally invasive surfactant therapy as an effective strategy to prevent respiratory complications in neonatal care — read on for a detailed summary of this important study.
Continuous positive airway pressure failure in preterm infants: incidence, predictors and consequences (2013)
Dargaville PA, Aiyappan A, De Paoli AG, Dalton RGB, et al.
This pivotal study examined CPAP failure in preterm infants with RDS, identifying low gestational age (GA) and high oxygen requirements as primary predictors. Infants who failed CPAP faced significantly higher rates of BPD, pneumothorax, and prolonged respiratory support compared with those who successfully maintained CPAP.
Read about how this study underscored the critical importance of early intervention in improving respiratory outcomes and helped inform the FiO₂ thresholds that are now established in European guidelines.
Fraction of Inspired Oxygen as a Predictor of CPAP Failure in Preterm Infants with Respiratory Distress Syndrome: A Prospective Multicenter Study (2019)
Gulczyńska E, Szczapa T, Hożejowski R , Borszewska-Kornacka MK, Rutkowska M.
This study underscored the importance of CPAP success in preterm infants with RDS and identified key factors that influenced clinical outcomes. Low GA, low birth weight and an FiO₂ threshold exceeding 0.29 in the second hour of life were significant predictors of CPAP failure, with infants above this oxygen requirement facing higher risks of complications such as BPD and pneumothorax, as well as an increased likelihood of requiring mechanical ventilation.
Discover how this study has helped shaped guideline recommendations, supporting standardised approaches to enhance CPAP success and improve outcomes in neonatal care.
Incidence and Outcome of CPAP Failure in Preterm Infants (2016)
Dargaville PA, Gerber A, Johansson S, De Paoli AG, , et al.
This study emphasised the crucial role of early intervention in ensuring CPAP success for preterm infants with RDS. It identified CPAP failure as relatively common, especially in infants less than 29 weeks GA, with key risk factors including low birth weight, incomplete antenatal steroid exposure, and Caesarean delivery without labour. CPAP failure was closely linked to adverse outcomes, including higher rates of pneumothorax, BPD, and longer hospital stays.
Read about how these findings highlighted the importance of early, proactive strategies to prevent CPAP failure, contributing to the development of guidelines that reinforce early intervention as essential for managing preterm infants on CPAP.