CeasIng Cpap At standarD criteriA (CICADA): impact on weight gain, time to full feeds and caffeine use

Introduction In our previous randomised controlled trial (RCT), we have shown in preterm babies (PBs) <30 weeks gestation that CeasIng Cpap At standarD criteriA (CICADA (method 1)) compared with cycling off continuous positive airway pressure (CPAP) gradually (method 2) or cycling off CPAP gradually with low flow airoxygen during periods off CPAP (method 3) reduces CPAP cessation time in PBs <30 weeks gestation. Method This retrospective study reviewed weight gain, time to reach full feeds and time to cease caffeine in PBs previously enrolled in the RCT. Results Data were collected from 162 of the 177 PBs, and there was no significant difference in the projected weight gain between the three methods. Based on intention to treat, the time taken to reach full feeds for all three methods showed no significant difference. However, post hoc analysis showed the CICADA method compared with cycling off gradually just failed significance (30.3 +/- 1.6 vs 31.1 +/- 2.4 (weeks corrected gestational age (Wks CGA +/- SD)), p=0.077). Analysis of time to cease caffeine showed there was a significant difference between the methods with PBs randomised to the CICADA method compared with the cycling off method ceasing caffeine almost a week earlier (33.6 +/- 2.4 vs 34.5 +/- 2.8 (Wks CGA +/- SD), p=0.02). Conclusions This retrospective study provides evidence to substantiate the optimum method of ceasing CPAP; the CICADA method, does not adversely affect weight gain, time to reach full feeds and may reduce time to cease caffeine in PBs <30 weeks gestation.