CPAP use in babies with respiratory distress in Australian special care nurseries

Aim: This study sought to identify the number of special care nurseries (SCNs) already using CPAP in 2004, and the number considering its use in the following 2 years, and to describe the characteristics of those hospitals. Methods: All Australian hospitals with > 200 registered deliveries in the year 2002, a SCN and at least one paediatrician were eligible (n = 157). Separate questionnaires were sent to the nurse unit manager (NUM) and the paediatrician responsible for the SCN in late 2004. Results: Of 157 eligible SCNs, 143 (91%) responded. CPAP was being used in 24/143 (17%). Of those nurseries not already using CPAP a further 45/119 (38%) were considering doing so in 2005/2006. State/Territory, greater availability of junior medical staff, use of a helicopter/airplane for transferring infants to tertiary centres and number of paediatricians were significantly associated with use of CPAP (all P < 0.05). Consideration of use was significantly associated with greater availability of junior medical staff, larger numbers of births and time to nearest (tertiary) centre (all P < 0.05). Conclusion: There is a strong predisposition for the use of CPAP in SCNs despite the lack of evidence for its benefits or risks there. Studies are urgently required on the clinical benefits and risks of CPAP in a non-tertiary centre before the widespread introduction of CPAP takes place.