Extended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial.

Its effect on lung growth after discharge is unknown.

其出院后对肺生长的影响尚不清楚。

Objectives: To assess whether 2 weeks of eCPAP in stable preterm infants is associated with increased alveolar volume (Va) at 6 months corrected age.

目的：评估在稳定的早产儿中，连续2周使用eCPAP是否与6个月矫正年龄时肺泡体积（Va）增加有关。

Methods: This randomized controlled trialwas conducted at Oregon Health & Science University.

方法：该随机对照试验在俄勒冈健康与科学大学进行。

Outpatient assessors were unaware of treatment assignment.

门诊评估者不知道治疗分配情况。

One hundred infants were randomized to eCPAP versus CPAP discontinuation (dCPAP) to room air.

一百名婴儿被随机分配到eCPAP与CPAP停用（dCPAP）对比室内空气。

Measurements and Main Results: The primary outcome was Va by the single breath hold technique at 6 months corrected age.

测量和主要结果：主要结果是通过单次屏气技术在矫正6个月龄时测量的肺泡通气量(Va)。

Secondary outcomes included DlCO and forced expiratory flows (FEFs).

次要结果包括一氧化碳弥散量(DlCO)和用力呼气流速(FEFs)。

FRC was measured in the NICU.

在新生儿重症监护病房(NICU)测量了功能残气量(FRC)。

Infants randomized to eCPAP (n = 54) versus dCPAP (n = 46) had the following measurements shown as adjusted mean (SE): Va (500.2 [24.9] vs. 418.1 [23.4] ml; adjusted mean difference, 82.1 [95% confidence interval(CI), 8.3-155.9]; P = 0.033); DlCO (3.4 [0.2] vs. 2.8 [0.1] ml/min/mm Hg; adjusted mean difference, 0.6 [95% CI, 0.1-1.1]; P = 0.018); measurement of FEF at 50% of the expired volume (500.6 [18.2] vs. 437.9 [17.9] ml/s; adjusted mean difference, 62.7 [95% CI, 4.5-121.0]; P = 0.039); FEF between 25% and 75% of expired volume (452.0 [17.4] vs. 394.4 [17.4] ml/s; adjusted mean difference, 57.5 [95% CI, 1.3-113.8]; P = 0.046).

随机分配到eCPAP (n = 54)与dCPAP (n = 46)的婴儿，以下测量值显示为调整后的平均值（标准误）：潮气量Va（500.2 [24.9] vs. 418.1 [23.4]毫升；调整后的平均差异，82.1 [95%置信区间(CI), 8.3-155.9]；P = 0.033）；肺一氧化碳弥散量DlCO（3.4 [0.2] vs. 2.8 [0.1]毫升/分钟/毫米汞柱；调整后的平均差异，0.6 [95% CI, 0.1-1.1]；P = 0.018）；在呼出体积50%时测量的呼气流量FEF（500.6 [18.2] vs. 437.9 [17.9]毫升/秒；调整后的平均差异，62.7 [95% CI, 4.5-121.0]；P = 0.039）；在呼出体积25%至75%之间测量的呼气流量FEF（452.0 [17.4] vs. 394.4 [17.4]毫升/秒；调整后的平均差异，57.5 [95% CI, 1.3-113.8]；P = 0.046）。

Conclusions: Infants randomized to eCPAP versus dCPAP had significantly increased Va at 6 months corrected age.

结论：与dCPAP相比，随机分配到eCPAP的婴儿在纠正年龄6个月时的通气量(Va)显著增加。

DlCO and FEFs were also increased.

一氧化碳弥散量(DlCO)和用力呼气流量(FEFs)也有所增加。

Extending CPAP in stable preterm infants in the NICU may be a nonpharmacologic and safe therapy to promote lung growth.

在新生儿重症监护病房（NICU）中，对稳定的早产儿延长使用持续气道正压通气（CPAP）可能是一种非药物且安全的疗法，以促进肺部生长。

Clinical trial registered with www.clinicaltrials.gov (NCT04295564).

该临床试验已在 www.clinicaltrials.gov 注册，注册号为 NCT04295564。