Comparing Bubble and Ventilator Nasal CPAP in Preterm Infants

There are various methods to generate the pressure needed for Nasal CPAP. Some neonatal
intensive care units (NICU) use an underwater bubbling system and others use a ventilator to
generate the pressure. There is no right or wrong way to generate the pressure and both
methods are approved and accepted.

The aim of this study is to compare the two systems of Nasal CPAP by placing the baby on
each for a defined time period and reviewing the infant's vital signs. The investigators
expect that the pressure generated by bubble CPAP will be better and lead to improved vital
signs.

Inclusion Criteria:

- Neonates between 26-32 weeks gestational age who have been on Nasal CPAP for at least
48hrs on fraction of inspired oxygen (FiO2) of < or = 0.3. Parental consent will be
obtained prior to enrollment.

Exclusion Criteria:

- Infants with severe congenital anomalies, such as airway or chest wall deformities,
pulmonary hypoplasia, congenital heart disease, neurologic abnormalities including
severe intraventricular hemorrhage (IVH) and need for surgery eg. for necrotizing
enterocolitis will be excluded from the study. Any infants with genetic/chromosomal
abnormalities will be excluded.