PT - JOURNAL ARTICLE AU - Wood, FE AU - Gupta, S AU - Tin, W AU - Sinha, S TI - G170 Randomised Controlled Trial of Synchronised Intermittent Positive Airway Pressure (SiPAP™) Versus Continuous Positive Airway Pressure (CPAP) as a Primary Mode of Respiratory Support in Preterm Infants with Respiratory Distress Syndrome AID - 10.1136/archdischild-2013-304107.182 DP - 2013 Jun 01 TA - Archives of Disease in Childhood PG - A78--A78 VI - 98 IP - Suppl 1 4099 - http://adc.bmj.com/content/98/Suppl_1/A78.1.short 4100 - http://adc.bmj.com/content/98/Suppl_1/A78.1.full SO - Arch Dis Child2013 Jun 01; 98 AB - Background Minimising exposure to factors contributing to chronic respiratory morbidity is a priority in preterm care. CPAP is established but alternatives are gaining popularity despite limited evaluation. SiPAP has not previously been compared to CPAP for first-line treatment of RDS. Aims To compare SiPAP with CPAP as a primary mode of non-invasive respiratory support in premature infants with RDS. Methods In this prospective two-centre trial, infants (GA 28+0 to 31+6; inborn; <6hrs old; no prior intubation; no major congenital disorders) were assigned to either SiPAP (BiPhasic Tr©) or CPAP delivered by the Infant Flow® SiPAP™ device. Randomisation was stratified by centre and gestation. Crossover or use of other devices was not permitted. The primary outcome was a pre-defined failure of non-invasive respiratory support, necessitating intubation and ventilation, in the first 72 hours of treatment. Strategies for initial settings, weaning, discontinuation and deterioration were specified. To detect a 50% reduction in failure (power 80%, α = 0.05, 2 tailed), 116 participants were required. Analyses were by intention-to-treat. Results We assessed 368 infants at admission and recruited 120 of 149 eligible (CPAP 60, SiPAP 60). Baseline characteristics were comparable. View this table:Abstract G170 Table 1 Failure of non-invasive respiratory support, did not differ by allocated mode of respiratory support but occurred more frequently in the lower gestational age stratum (GA < 30+0) (p = 0.004). Despite differing frequencies for some key morbidities there were no significant differences in secondary outcomes. View this table:Abstract G170 Table 2 Conclusions For the very preterm infant, using SiPAP for first-line treatment of RDS does not confer any benefit in short-term respiratory outcome as compared to CPAP. Preterm morbidities and complications of non-invasive respiratory support were similar irrespective of allocation in this study.