{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:59:56Z","timestamp":1776128396223,"version":"3.50.1"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continuous positive airway pressure (CPAP) postextubation in preterm neonates. However, studies have not permitted high CPAP pressures or rescue with other modes. We hypothesized that if CPAP pressures &amp;gt;8 cmH2O and rescue with other modes were permitted, CPAP would be noninferior to NIPPV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We conducted a pragmatic, comparative-effectiveness, noninferiority study utilizing network-based real-world data from 22 Canadian NICUs. Centers self-selected CPAP or NIPPV as their standard postextubation mode for preterm neonates &amp;lt;29 weeks\u2019 gestation. The primary outcome was failure of the initial mode \u226472 hours. Secondary outcomes included failure \u22647 days, and reintubation \u226472 hours and \u22647 days. Groups were compared using a noninferiority adjusted risk-difference (aRD) margin of 0.05, and margin of no difference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 843 infants extubated to CPAP and 974 extubated to NIPPV were included. CPAP was not noninferior (and inferior) to NIPPV for failure of the initial mode \u226472 hours (33.0% vs 26.3%; aRD 0.07 [0.03 to 0.12], Pnoninferiority(NI) = .86), and \u22647 days (40.7% vs 35.8%; aRD 0.09 [0.05 to 0.13], PNI = 0.97). However, CPAP was noninferior (and equivalent) to NIPPV for reintubation \u226472 hours (13.2% vs 16.1%; aRD 0.01 [\u22120.05 to 0.02], PNI &amp;lt; .01), and noninferior (and superior) for reintubation \u22647 days (16.4% vs 22.8%; aRD \u22120.04 [\u22120.07 to \u22120.001], PNI &amp;lt; .01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>CPAP was not noninferior to NIPPV for failure \u226472 hours postextubation; however, it was noninferior to NIPPV for reintubation \u226472 hours and \u22647 days. This suggests CPAP may be a reasonable initial postextubation mode if alternate rescue strategies are available.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2023-064045","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T08:06:00Z","timestamp":1711008360000},"source":"Crossref","is-referenced-by-count":7,"title":["CPAP Versus NIPPV Postextubation in Preterm Neonates: A Comparative-Effectiveness Study"],"prefix":"10.1542","volume":"153","author":[{"given":"Amit","family":"Mukerji","sequence":"first","affiliation":[{"name":"aMcMaster Children\u2019s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke","family":"Read","sequence":"additional","affiliation":[{"name":"bLondon Health Sciences Centre, London, Ontario, 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