sararn1

We use Sipap and NCPAP exclusively. I do not like High Flow Cannula because I think it increases the work of breathing after using the Infant Flow driver that has the fluidic flip. In my opinion a nasal cannula is a step backward from NCPAP. We have been very successful with NCPAP on babies 27 weeks and above. Below 27 weeks we usually put on HFOV to get Curosurf then extubate within 48 - 72 hours to NCPAP. Our chronic lung disease (

What type of cpap device do you use? I know most places don't use decadron anymore but when you get to the point of traching a baby you sometimes take extreme measures. Have you considered a short course to help him wean?

We have recently had a similar problem. I did some research and found that these type babies, (I am assuming he was a VLBW preemie) are sometimes left on CPAP too long before the weaning process begins. There are few if any weaning guidelines out there and I have looked! So I took what we hope to be the ideal time to start weaning and I have written our own NCPAP guidelines and I restate these are only guidelines because we all know babies never do what you expect. (Also there are no real studies to look at so my guidelines are written just from our own exerience.) We never use a nasal cannula unless the baby is cardiac or the rare baby who was on the vent and in O2 forever who doesn't require PEEP but requires O2. Our first goal is to wean off oxygen so that is our first priority. ( We never use a PEEP >6 because at this point we would oscillate the baby for a few days and try him off later. ) When these babies reach 29+ weeks and are in room air for 72 hours we start weaning but not the PEEP which in our unit 99% of the time 5. We wean by time off/time on. Term and near term babies who are here for TTN or mild RDS are weaned differently. We have not had a baby who had to be trached in at least 10 years.