Episode Details
Back to Episodes#466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants?
Description
Ben and Daphna dig into a pilot RCT that asks a deceptively simple delivery-room question: should very preterm infants start on CPAP of 5 or CPAP of 8 cmH2O? The PHILODENDRON trial, out of Milan's Buzzi Children's Hospital, randomized 56 babies born between 26 and 29 weeks to find out — testing feasibility, safety, and early physiological adaptation before committing to a larger multicenter trial. No major safety signals emerged, but babies on lower CPAP reached surfactant thresholds faster, while higher CPAP trended toward fewer air leaks and shorter ventilation. Ben and Daphna weigh the physiology against the data, and ask whether trials like this even test the right question in the first place.
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Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial.
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