A modified physiologic test for bronchopulmonary dysplasia: A clinical tool for weaning from CPAP and/or oxygen-therapy the premature babies?

Background: A physiologic test for estimating BPD rate has been developed by Walsh and collaborators. Actually there are not standard criteria for weaning from CPAP and/or oxygen therapy the premature babies. Aim of this study was to verify if a physiologic test, modified respect to that developed by Walsh and collaborators for estimating BPD rate, can be used as a clinical tool for weaning the premature babies from CPAP and/or oxygen therapy. Methods: Neonates with BW 500-1250 g and GA ≤ 32 weeks, receiving FiO 2 ≤ 0.30 by hood or CPAP, were prospectively studied at 28 days of life and at 36 weeks of postmestrual age. The test was performed in 3 steps: baseline, challenge (FiO 2 and CPAP reduction to room air) and post test (room air). Monitoring of transcutaneous CO 2 was added to SpO 2 and the newborns passing the test were left in room air. Results: Six of 23 tested babies (26%) passed the challenge at 28 days of life, 4 of 10 tested babies (40%) passed the challenge at 36 weeks. Median values of SpO 2 were significantly higher in the neonates passing the test, respect to the failing patients. At the same time median values of TcPCO 2 were significantly higher in the latter babies. Conclusion: TcPCO 2 monitoring appeared to be a new useful parameter for failure prediction of weaning. The test represented a clinical guide because the newborns passing it were left in room air.