{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:29:23Z","timestamp":1790036963531,"version":"4.0.1"},"reference-count":20,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2014,6,25]]},"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>We hypothesised that short-term application of bi-level nasal continuous positive airway pressure CPAP (SiPAP) compared with conventional nasal CPAP (nCPAP) at the same mean airway pressure in infants with persistent oxygen need recovering from respiratory distress syndrome would improve CO<jats:sub>2<\/jats:sub> removal with no change in oxygen requirement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Non-blinded, randomised, observational four-period crossover study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting\/population<\/jats:title>\n                  <jats:p>Level III NICU; low-birthweight infants requiring CPAP and oxygen while recovering from respiratory distress syndrome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Infants requiring nasal CPAP for &gt;24\u2005h prior to study enrolment, and fraction of inspired oxygen requirement (FiO<jats:sub>2<\/jats:sub>) of 0.25\u20130.5, were randomised to either nCPAP or SiPAP. A crossover design with four 1 h treatment periods was used such that each infant received both treatments twice. Oxygen saturations (SaO<jats:sub>2<\/jats:sub>), transcutaneous CO<jats:sub>2<\/jats:sub> (tcCO<jats:sub>2<\/jats:sub>) and vital signs were monitored continuously. Polysomnographic recordings were analysed for apnoea, bradycardia and oxygen desaturation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty low-birthweight infants receiving 0.3\u00b10.04% supplemental oxygen on CPAP of 6 cm H<jats:sub>2<\/jats:sub>O were studied at an average of 33\u2005days of age (\u00b123\u2005days, SD). There were no differences in tcCO<jats:sub>2<\/jats:sub> or other physiological parameters except mean blood pressure, which was lower during nCPAP (52.3\u00b18.3 vs 54.4\u00b19.1\u2005mm\u2005Hg; \u00b1SD; p&lt;0.01). No differences in short or prolonged apnoea, bradycardia or significant desaturation events were observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>At similar mean airway pressures, SiPAP does not improve CO<jats:sub>2<\/jats:sub> removal, oxygenation or other studied physiological parameters with the exception of mean blood pressure, which was not clinically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NCT01053455.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fetalneonatal-2013-305665","type":"journal-article","created":{"date-parts":[[2014,8,2]],"date-time":"2014-08-02T00:47:02Z","timestamp":1406940422000},"page":"F31-F34","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Bi-level CPAP does not improve gas exchange when compared with conventional CPAP for the treatment of neonates recovering from respiratory distress syndrome"],"prefix":"10.1136","volume":"100","clinical-trial-number":[{"clinical-trial-number":"nct01053455","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Andrea L","family":"Lampland","sequence":"first","affiliation":[{"name":"Infant Diagnostic & Research Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota, USA"},{"name":"Department of Pediatrics\u2014Neonatology, University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Plumm","sequence":"additional","affiliation":[{"name":"Infant Diagnostic & Research Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Worwa","sequence":"additional","affiliation":[{"name":"Infant Diagnostic & Research Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Meyers","sequence":"additional","affiliation":[{"name":"Infant Diagnostic & Research Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C","family":"Mammel","sequence":"additional","affiliation":[{"name":"Infant Diagnostic & Research Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota, USA"},{"name":"Department of Pediatrics\u2014Neonatology, University of Minnesota, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,8,1]]},"reference":[{"key":"2025090511265914000_100.1.F31.1","first-page":"CD003063","article-title":"Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome","volume":"3","author":"Stevens","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090511265914000_100.1.F31.2","unstructured":"Fanaroff A Martin J . Neonatal-perinatal medicine, 7th edn. St Louis, MO: Mosby-Year Book, Inc., 2001:1003."},{"key":"2025090511265914000_100.1.F31.3","doi-asserted-by":"publisher","DOI":"10.1159\/000326843"},{"key":"2025090511265914000_100.1.F31.4","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000025341.25481.42"},{"key":"2025090511265914000_100.1.F31.5","doi-asserted-by":"publisher","DOI":"10.1007\/s004310050620"},{"key":"2025090511265914000_100.1.F31.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072788"},{"key":"2025090511265914000_100.1.F31.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911783"},{"key":"2025090511265914000_100.1.F31.8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-3848"},{"key":"2025090511265914000_100.1.F31.9","first-page":"CD000143","article-title":"Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants","volume":"2","author":"Davis","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090511265914000_100.1.F31.10","first-page":"CD003212","article-title":"Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation","volume":"3","author":"Davis","year":"2001","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090511265914000_100.1.F31.11","first-page":"CD002272","article-title":"Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for apnea of prematurity","volume":"1","author":"Lemyre","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090511265914000_100.1.F31.12","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20276"},{"key":"2025090511265914000_100.1.F31.13","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.169219"},{"key":"2025090511265914000_100.1.F31.14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-12-43"},{"key":"2025090511265914000_100.1.F31.15","doi-asserted-by":"publisher","DOI":"10.1186\/cc3877"},{"key":"2025090511265914000_100.1.F31.16","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.203190"},{"key":"2025090511265914000_100.1.F31.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214533"},{"key":"2025090511265914000_100.1.F31.18","first-page":"CD000456","article-title":"Synchronized mechanical ventilation for respiratory support in newborn infants","volume":"1","author":"Greenough","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090511265914000_100.1.F31.19","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2011.117"},{"key":"2025090511265914000_100.1.F31.20","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181ff6770"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fetalneonatal-2013-305665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:51:39Z","timestamp":1757098299000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fetalneonatal-2013-305665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,1]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,12,14]]},"published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1136\/fetalneonatal-2013-305665"],"URL":"https:\/\/doi.org\/10.1136\/fetalneonatal-2013-305665","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,1]]}}}