Breathing new life into premature baby care: McMaster research strives to enhance respiratory support without tubes

Researcher: Amit Mukerji
CIHR Funding: $367,199 / 3.5 years

Premature babies often require breathing assistance, and while traditional methods involve a tube in the windpipe, this can lead to lung injury and long-term issues. Clinicians caring for these tiny patients remove the tube as soon as possible and replace it with a nasal breathing mask – believed to be a gentler treatment. However, up to one-third of the time, the breathing tube needs to be put back in, which in turn is associated with health complications.

At McMaster Children’s Hospital, neonatologist and associate professor of pediatrics Amit Mukerji wants to refine the use of nasal breathing support to increase the success rate of removing the breathing tube. Currently, the optimal pressure levels for starting nasal breathing support are unknown. Some studies suggest higher pressure might be better, but it still needs to be proven.

Mukerji’s three-year-long research study is in collaboration with 22 Canadian hospitals and will compare two pressure levels – higher vs. standard – in relation to the pressures from the breathing tube. Half of the hospitals will use higher pressures for eligible babies, while the others will use standard pressures. The goal is to determine if higher pressures increase the success of removing the breathing tube.

If proven effective and safe, using higher pressures in nasal support after removal of the breathing tube could revolutionize preterm baby care, leading to immediate changes that improve outcomes.

Mukerji says there’s a delicate balance between effective treatment and minimizing potential health complications when treating premature babies. “This collaborative, multi-hospital study holds the potential to greatly improve preterm baby care, which means a brighter and healthier future for children and their families.”

Read more: Post-extubation pressures on non-invasive respiratory support in preterm neonates: A prospective comparative effectiveness research study