The rational use of nasal continuous positive airway pressure

Abstract Nasal continuous positive airway pressure is a well-established modality for providing ventilatory support to spontaneously breathing infants. It has been used in a variety of clinical situations. A major area of use has been as a second-line therapy to support preterm infants following extubation from mechanical ventilation. Recent reports of the use of continuous positive airway pressure instead of mechanical ventilation, early in the course of respiratory distress syndrome, have generated renewed interest and debate among clinicians. These reports have also highlighted the need for further research. This article reviews the current use of the technique, its physiological effects and its clinical benefits as well as its limitations and adverse effects.