Evidence map›Paper›PMID 20472939›Full record

Trial reportThe New England journal of medicine2010

Early CPAP versus surfactant in extremely preterm infants.

SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network, Neil N Finer, Waldemar A Carlo, Michele C Walsh, Wade Rich, Marie G Gantz, Abbot R Laptook, Bradley A Yoder, Roger G Faix, Abhik Das and 20 more

Erratum issued 10 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 10 registered trials, which are not on this map. Cited by 411 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
411citing papers in PubMed, 16 pooled it
55.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00233324 phase3completednot on this map

Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) in Extremely Low Birth Weight Infants

TypeinterventionalSponsorNICHD Neonatal Research NetworkRan2005 to 2016Enrolled1,316ConditionsInfant, Newborn, Diseases, Other Preterm Infants, Infant, Small for Gestational Age, Premature BirthArmsSurfactant, Continuous Positive Airway Pressure (CPAP), Supplemental oxygen with target saturation of 85 to 89%, Supplemental oxygen with target saturation of 91 to 95%
NCT01739114 nacompletednot on this mapstarted 2013, after this paper: background citation

Sustained Inflations to Achieve Lung Aeration at Birth - a Randomized Control Trial

TypeinterventionalSponsorUniversity of AlbertaRan2013 to 2014Enrolled186ConditionsBronchopulmonary DysplasiaArms"IPPV group", SI group
NCT02482766 nacompletednot on this mapstarted 2015, after this paper: background citation

Efficacy of a New Technique -"IN-REC-SUR-E"- in Preterm Neonates With Respiratory Distress Syndrome During Non Invasive Ventilation: a Randomized Controlled Trial

TypeinterventionalSponsorCatholic University of the Sacred HeartRan2015 to 2018Enrolled206ConditionsRespiratory Distress Syndrome, Hyaline Membrane DiseaseArmsPoractant alfa, 200 mg/kg, Ventilator for High-frequency Oscillatory Ventilation (HFOV), Nasal Continuous Positive Airway Pressure (nCPAP)
NCT02819050 nacompletednot on this mapstarted 2014, after this paper: background citation

A Prospective Randomized Controlled Tiral Comparing Sprinting Versus Non-sprinting Approach to Wean Nasal Continous Positive Airway Pressure Support in Premature Infants Born at Less Than 30 Weeks Gestational Age

TypeinterventionalSponsorLundquist Institute for Biomedical Innovation at Harbor-UCLA Medical CenterRan2014 to 2016Enrolled80ConditionsNeonatal Respiratory Distress Syndrome, Extremely Low Birth Weight Infant (ELBW), BronchoPulmonary DysplasiaArmsNCPAP
NCT03086473 phase4unknown statusnot on this mapstarted 2017, after this paper: background citation

A Randomized, Placebo-controlled Trial of Early Caffeine in Preterm Neonates

TypeinterventionalSponsorJennifer ShepherdRan2017 to 2022Enrolled24ConditionsBPD - Bronchopulmonary Dysplasia, Apnea of Prematurity, Hemodynamic Instability, IntubationArmsCaffeine Citrate, Placebo (Normal Saline)
NCT04000568 completednot on this mapstarted 2019, after this paper: background citation

Breathing Pattern Variability in Preterm Infants: Effect of Non-invasive Neurally Adjusted Ventilatory Assist (NAVA-NIV) Versus Nasal Intermittent Positive Pressure Ventilation (PC-NIV), a Crossover Study

TypeobservationalSponsorFondazione IRCCS Ca' Granda, Ospedale Maggiore PoliclinicoRan2019 to 2022Enrolled25ConditionsNeonatal Respiratory Distress Syndrome, PrematurityArmsRespiratory support: NAVA -NIV and PC-NIV
NCT04209946 nacompletednot on this mapstarted 2020, after this paper: background citation

A Multicenter, Randomized Trial of Preterm Infants Receiving Caffeine and Less Invasive Surfactant Administration Compared to Caffeine and Early Continuous Positive Airway Pressure (CaLI Trial)

TypeinterventionalSponsorSharp HealthCareRan2020 to 2025Enrolled180ConditionsPremature Lungs, Respiratory Distress Syndrome, Surfactant Deficiency Syndrome NeonatalArmsLess Invasive Surfactant Administration LISA, Continuous Positive Airway Pressure CPAP
NCT04413097 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

Delayed Cord Clamping With Oxygen In Extremely Low Gestation Infants

TypeinterventionalSponsorSharp HealthCareRan2021 to 2026Enrolled140ConditionsIVH- Intraventricular Hemorrhage, Extreme Prematurity, Hypoxia Neonatal, HyperoxiaArmsDelayed Cord Clamping with Low Oxygen concentration, Delayed Cord Clamping with High Oxygen concentration
NCT04820101 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Dexmedetomidine for LISA Procedure in Preterm Infants: a Pilot Study

TypeinterventionalSponsorUniversity of PadovaRan2021 to 2023Enrolled40ConditionsRDSArmsDexmedetomidine
NCT06007547 phase4recruitingnot on this mapstarted 2024, after this paper: background citation

Prophylactic Minimally Invasive Surfactant Evaluation

TypeinterventionalSponsorEndeavor HealthRan2024 to 2027Enrolled200ConditionsRespiratory Distress Syndrome, Newborn, Premature BirthArmsPoractant Alfa
3 · Its place in the literature

Who cites it

411 citing papers in PubMed, 16 syntheses or guidelines pooled it, 1,018 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Thresholds for surfactant use in preterm neonates: a network meta-analysis.Archives of disease in childhood. Fetal and neonatal edition · 2023
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Guideline
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Sustained inflations and avoiding mechanical ventilation to prevent death or bronchopulmonary dysplasia: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2018
    Pooled it
  17. Trial
  18. Trial
  19. Trial
  20. Trial

351 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors.

SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network
Neil N Finer
Waldemar A Carlo
Michele C Walsh
Wade Rich
Marie G Gantz
Abbot R Laptook
Bradley A Yoder
Roger G Faix
Abhik Das
W Kenneth Poole
Edward F Donovan
Nancy S Newman
Namasivayam Ambalavanan
Ivan D Frantz
Susie Buchter
Pablo J Sánchez
Kathleen A Kennedy
Nirupama Laroia
Brenda B Poindexter
C Michael Cotten
Krisa P Van Meurs
Shahnaz Duara
Vivek Narendran
Beena G Sood
T Michael O'Shea
Edward F Bell
Vineet Bhandari
Kristi L Watterberg
Rosemary D Higgins

Funding

Neonatal Research Network Data Coordinating Center (DCC)U10HD036790 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI DAS, ABHIK · 2008 to 2017
$62.3M
YALE UNIVERSITY CLINICAL AND TRANSLATIONAL SCIENCE AWARD PROGRAMUL1RR024139 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$56.8M
UNM HSC Clinical and Translational Science CenterUL1TR001449 · NCATS · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI CAMPEN, MATTHEW J, PANDHI, NANCY · 2015 to 2024
$36.9M
WORKER PROTECTION AGAINST AIRBORNE INFLUENZA - A PILOT STUDYM01RR007122 · NCRR · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUNDLEY, WILLIAM GREGORY · 1992 to 2010
$35.2M
UNIVERSITY OF IOWA CTSA FOR PEDIATRIC RESEARCHUL1RR024979 · NCRR · UNIVERSITY OF IOWA · PI ROSENTHAL, GARY E · 2007 to 2011
$31.8M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025008 · NCRR · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2007 to 2011
$29.0M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Stanford Center for Clinical and Translational Education and Research (SCCTER)UL1UL1RR025744 · NCRR · STANFORD UNIVERSITY · PI GREENBERG, HARRY BERNARD · 2008 to 2011
$22.4M
Data Ctr for the Cooperative Neonatal Research NetworkU01HD036790 · NICHD · RESEARCH TRIANGLE INSTITUTE · PI DAS, ABHIK · 1998 to 2007
$21.8M
VITAMIN K DEFICIENCY IN CHOLESTATIC LIVER DISEASEM01RR008084 · NCRR · CINCINNATI CHILDRENS HOSP MED CTR · PI HEUBI, JAMES E. · 1994 to 2009
$20.6M
XOMAZYME-CD5 PLUS THERAPY IN RHEUMATOID ARTHRITISM01RR000030 · NCRR · DUKE UNIVERSITY · PI WILLIAMS, R SANDERS · 1985 to 2006
$20.0M
University of New Mexico Clinical and Translational Science CenterUL1TR000041 · NCATS · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI LARSON, RICHARD S · 2012 to 2014
$9.8M
NCATS NIH HHS UL1 TR000041NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1 TR001449NCRR NIH HHS M01 RR000030NCRR NIH HHS M01 RR006022NCRR NIH HHS M01 RR007122NCRR NIH HHS M01 RR008084NCRR NIH HHS M01 RR016587NCRR NIH HHS M01 RR125NCRR NIH HHS M01 RR16587NCRR NIH HHS M01 RR30NCRR NIH HHS M01 RR32NCRR NIH HHS M01 RR39NCRR NIH HHS M01 RR44NCRR NIH HHS M01 RR54NCRR NIH HHS M01 RR59NCRR NIH HHS M01 RR6022NCRR NIH HHS M01 RR633NCRR NIH HHS M01 RR64NCRR NIH HHS M01 RR70NCRR NIH HHS M01 RR7122NCRR NIH HHS M01 RR750NCRR NIH HHS M01 RR80NCRR NIH HHS M01 RR8084NCRR NIH HHS M01 RR997NCRR NIH HHS UL1 RR024139NCRR NIH HHS UL1 RR024979NCRR NIH HHS UL1 RR025008NCRR NIH HHS UL1 RR025744NCRR NIH HHS UL1 RR24139NCRR NIH HHS UL1 RR24979NCRR NIH HHS UL1 RR25008NCRR NIH HHS UL1 RR25744NICHD NIH HHS U01 HD036790NICHD NIH HHS U10 HD021364NICHD NIH HHS U10 HD021373NICHD NIH HHS U10 HD021385NICHD NIH HHS U10 HD021397NICHD NIH HHS U10 HD027851NICHD NIH HHS U10 HD027853NICHD NIH HHS U10 HD027856NICHD NIH HHS U10 HD027871NICHD NIH HHS U10 HD027880NICHD NIH HHS U10 HD027904NICHD NIH HHS U10 HD034216NICHD NIH HHS U10 HD036790NICHD NIH HHS U10 HD040461NICHD NIH HHS U10 HD040492NICHD NIH HHS U10 HD040498NICHD NIH HHS U10 HD040521NICHD NIH HHS U10 HD040689NICHD NIH HHS U10 HD053089NICHD NIH HHS U10 HD053109NICHD NIH HHS U10 HD053119NICHD NIH HHS U10 HD053124NICHD NIH HHS U10 HD21364NICHD NIH HHS U10 HD21373NICHD NIH HHS U10 HD21385NICHD NIH HHS U10 HD21397NICHD NIH HHS U10 HD27851NICHD NIH HHS U10 HD27853NICHD NIH HHS U10 HD27856NICHD NIH HHS U10 HD27871NICHD NIH HHS U10 HD27880NICHD NIH HHS U10 HD27904NICHD NIH HHS U10 HD34216NICHD NIH HHS U10 HD36790NICHD NIH HHS U10 HD40461NICHD NIH HHS U10 HD40492NICHD NIH HHS U10 HD40498NICHD NIH HHS U10 HD40521NICHD NIH HHS U10 HD40689NICHD NIH HHS U10 HD53089NICHD NIH HHS U10 HD53109NICHD NIH HHS U10 HD53119NICHD NIH HHS U10 HD53124NICHD NIH HHS UG1 HD027851NICHD NIH HHS UG1 HD027880NICHD NIH HHS UG1 HD034216NICHD NIH HHS UG1 HD040492NICHD NIH HHS UG1 HD053089NICHD NIH HHS UG1 HD053109
6 · The paper itself

Abstract

backgroundThere are limited data to inform the choice between early treatment with continuous positive airway pressure (CPAP) and early surfactant treatment as the initial support for extremely-low-birth-weight infants.

methodsWe performed a randomized, multicenter trial, with a 2-by-2 factorial design, involving infants who were born between 24 weeks 0 days and 27 weeks 6 days of gestation. Infants were randomly assigned to intubation and surfactant treatment (within 1 hour after birth) or to CPAP treatment initiated in the delivery room, with subsequent use of a protocol-driven limited ventilation strategy. Infants were also randomly assigned to one of two target ranges of oxygen saturation. The primary outcome was death or bronchopulmonary dysplasia as defined by the requirement for supplemental oxygen at 36 weeks (with an attempt at withdrawal of supplemental oxygen in neonates who were receiving less than 30% oxygen).

resultsA total of 1316 infants were enrolled in the study. The rates of the primary outcome did not differ significantly between the CPAP group and the surfactant group (47.8% and 51.0%, respectively; relative risk with CPAP, 0.95; 95% confidence interval [CI], 0.85 to 1.05) after adjustment for gestational age, center, and familial clustering. The results were similar when bronchopulmonary dysplasia was defined according to the need for any supplemental oxygen at 36 weeks (rates of primary outcome, 48.7% and 54.1%, respectively; relative risk with CPAP, 0.91; 95% CI, 0.83 to 1.01). Infants who received CPAP treatment, as compared with infants who received surfactant treatment, less frequently required intubation or postnatal corticosteroids for bronchopulmonary dysplasia (P<0.001), required fewer days of mechanical ventilation (P=0.03), and were more likely to be alive and free from the need for mechanical ventilation by day 7 (P=0.01). The rates of other adverse neonatal outcomes did not differ significantly between the two groups.

conclusionsThe results of this study support consideration of CPAP as an alternative to intubation and surfactant in preterm infants. (ClinicalTrials.gov number, NCT00233324.)

Indexed as

Continuous Positive Airway PressureInfant, Extremely Low Birth WeightInfant MortalityIntubation, IntratrachealApgar ScoreBronchopulmonary DysplasiaFemaleHospital MortalityHumansInfant, NewbornInfant, PrematureIntention to Treat AnalysisMaleOximetryOxygenOxygen Inhalation TherapyOxygenPulmonary Surfactants

Identifiers

PMID20472939
PMCPMC3071534
OpenAlexW1589536239

What OpenQuestion holds

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Read underepoch 390

Registered trials

and 4 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.