Utility of saturation trends to predict successful weaning of nasal CPAP in very preterm neonates - A prospective study

BACKGROUND: There is no objective criteria to wean CPAP in preterm neonates. We aimed to assess the accuracy of 'saturation trends' to predict successful CPAP discontinuation. METHODS: We included very preterm neonates who required CPAP. Index tests were 'saturation trends'. Outcome was successful CPAP discontinuation, defined as baby stable in room air for 72 h. RESULTS: We had 120 neonates with mean +/- SD gestation 28.6 +/- 1.8 weeks. 96 (80%) neonates had successful discontinuation and 24 (20%) failed. Neonates with successful discontinuation had significantly greater 'saturation trends' during 24 h before discontinuing CPAP compared to those who failed [64.3 (48.1-83.7) vs. 47.3 (23.0-65.0), p = 0.001]. Saturations > 95% while on CPAP with 21% FiO(2) for > 60% time had 63% sensitivity and 70% specificity to predict successful CPAP discontinuation. CONCLUSION: 'Saturation trends' is a readily available objective parameter that can be used to guide weaning CPAP in preterm neonates.