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COIN TRIAL: THE GREEK EXPERIENCE. NCPAP VERSUS IPPV FOR PRETERM NEONATES: IS NCPAP NEUROPROTECTIVE?
  1. G Broutis1,
  2. M Dasopoulou1,
  3. C Costalos1
  1. 1NICU, Alexandra Hospital, Athens, Greece

Abstract

Aim To evaluate neurodevelopment of preterms 25–28 weeks of gestation enrolled in the COIN trial with the application of a parental questionnaire by 1 year corrected gestation age.

Methods The questionnaire translated, validated and standardized, was constructed for the purpose of the COIN trial.

The trial highlighted the incidence of BPD after the early use of NCPAP compared to IPPV in neonates 25–28 weeks of gestation. Eligibility criteria were gestation age, no known condition that might adversely affect breathing and an ability to breathe 5 minutes after birth, despite of need for respiratory support. Ineligible were all infants that had been intubated before randomization or without a need for respiratory support Randomization to either NCPAP or intubation at 5 minutes was according to a sealed numbered envelope. Written consent was obtained. Forty-six of 616 infants enrolled in the multicentre trial. The questionnaire (5 of 6 items domains gross motor, fine motor, problem solving, personal-social, and communication scoring system) was applied by the first follow up appointment.

Results Of 46 neonates (25 NCPAP/6 deaths, 21 IPPV/5 deaths) 30 followed up by 1 year corrected gestation age. 1 from the IPPV compared to none from the CPAP group presented with gross and fine motor disability (score<15, score<27 respectively), who had been already attending physiotherapy. 5 and 4 respectively from the groups were problem solving low scorers (<25), communication (<15), and personal-social (<20).

Conclusion No significant difference regarding neurodevelopment between NCPAP and IPPV infants was recorded by 1 year corrected gestational age.

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