Nasal bi-level positive airway pressure (BiPAP) versus nasal continuous positive airway pressure (CPAP) in preterm infants ≤32 weeks: A retrospective cohort study

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To investigate whether Bi-level positive airway pressure (BiPAP), compared with nasal continuous positive airway pressure (CPAP), is a more effective therapeutic strategy in preterm infants ≤32 weeks.


All inborn infants between 26+1 and 32+6 weeks' gestation, admitted to the neonatal intensive care unit (NICU ) of Tongji Medical Hospital between 1 January, 2010 and 31 December, 2011 (the 2010–2011 cohort or CPAP cohort) and between 1 January, 2012 and 31 December, 2013 (the 2012–2013 cohort or BiPAP cohort), were retrospectively identified. The primary outcome was intubation in infants < 72 h of age; secondary outcomes were mortality and the incidence of bronchopulmonary dysplasia (BPD).


There were 213 in the 2010–2011 cohort and 243 infants in the 2012–2013 cohort. There were fewer infants intubated within the first 72 h of age in the 2012–2013 cohort than in the 2010–2011 cohort (15% vs. 23%, P < 0.05). Of the infants who received some form of positive airway pressure, 12/94 (13%) of infants on BiPAP versus 23/74 (31%) on CPAP were subsequently intubated (P < 0.01). There was no difference in the incidence of moderate and severe BPD between the two groups (7% vs. 8%, P=0.52).


In this retrospective cohort study, we found BiPAP, compared with CPAP, reduced the need for intubation within the first 72 h of age.

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