Optimal CPAP Weaning Approaches: A Scoping Review

Abstract

Background: Bronchopulmonary dysplasia (BPD) is a prevalent chronic lung disease affecting premature infants, leading to long-term respiratory complications, hospital readmissions, and significant financial burden on families and the health care system. BPD is caused by lung injury, making it crucial to focus on methods to minimize lung injury and prevent the transition from respiratory distress syndrome to BPD by following evidence-based respiratory support strategies.

Purpose: This scoping review examines methods for weaning preterm infants off continuous positive airway pressure (CPAP) and evaluates their effectiveness in maintaining respiratory independence. The review aims to map the existing literature, identify knowledge gaps, and suggest areas for further research to optimize the CPAP weaning process for preterm infants. Additionally, it provides an overview of respiratory distress syndrome and BPD.

Conclusion: Four randomized control trials comparing a combination pair of either sudden, gradual, non-sprinting, and sprinting weaning for premature infants are discussed, emphasizing the need for assessing infant readiness to facilitate successful weaning.

Implications for practice and research: Implementing evidence-based interventions consistency and using a stepwise approach can improve patient outcomes, irrespective of the weaning methodology employed.

Keywords: bronchopulmonary dysplasia; continuous positive airway pressure; infant; intensive care units; neonatal; newborn; respiratory distress syndrome.