1. Initiating bubble continuous positive airway pressure (CPAP) in the delivery room to spontaneously breathing neonates.

  2. Providing postextubation noninvasive respiratory support in the NICU to maintain functional residual capacity.

In 1987, 8 intensive care nurseries in large institutions in the United States, including a total of 1,625 infants with birthweights between 700 and 1,500 g, analyzed their rates of chronic lung disease and respiratory support practices. (1) They reported substantial differences in the incidence of chronic lung disease among institutions. One of the participating centers (Columbia University, New York, NY) had the lowest rate of chronic lung disease, which was attributed to initiation of CPAP in the delivery room. (1) Since then, several additional studies have illustrated the benefits of initiating CPAP treatment early in preterm infants, with improved pulmonary outcomes, including decreased number of ventilator days, (2)(3) fewer intubations, (3)...

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