Early versus delayed initiation of continuous negative pressure in infants with hyaline membrane disease.

Twenty-three infants with HMD of similar severity, who were less than 24 hours of age and who were breathing spontaneously, were divided by random numbers into early and delayed CNP groups. The infants who were treated with CNP before their PaO2 was less than 50 mm Hg while breathing 70% oxygen experienced a significantly greater increase in PaO2 in response to the initiation of CNP, required less time with O2 therapy, required no mechanical ventilation, and had fewer complications. Based on these results, it is suggested that CNP be initiated in infants with HMD, who are less than 24 hours of age and are breathing spontaneously, before the PaO2 becomes less than 50 mm Hg on 70% O2.