Hypoxemia Surrounding Enteral Feeds in Preterm Infants Receiving Extended Continuous Positive Airway Pressure

Objectives Hypoxemia is common in preterm infants and associated with morbidities. We evaluated the relationship between OG feeds and hypoxemia and the effect of extending CPAP. Design/Methods In this prospective substudy of the NHLBI-supported trial (NCT04295564), stable preterm infants were randomized to two additional weeks of CPAP (eCPAP) or CPAP discontinuation (dCPAP) to room air. Oxygen saturation was analyzed before, during, and after feeds in 30 infants. The primary outcome was percent time with SpO 2 <90%; secondary outcomes included percent time with SpO 2 <80%, IH episodes < 90% and < 80%. Results Infants randomized to eCPAP spent significantly less time with SpO 2 <90% than dCPAP infants before, during, and after feedings, including a 6.8 percentage-point reduction post-feed (p = 0.006). No differences were observed for SpO 2 <80%. eCPAP infants also experienced fewer IH episodes < 90% over the two-week study period (p = 0.02) Conclusions Extending CPAP reduced hypoxemia in preterm infants. OG feedings were not associated with increased hypoxemia or IH.