Evidence map›Paper›PMID 41429951›Full record

ArticlePediatric research2025

Metabolic response to extended continuous positive airway pressure in premature infants.

Philip L Ballard, Kelvin D MacDonald, Julia Harris, Thaybeth I Malave-Mendez, Mitzi Go, Alec Martin, Kristin Milner, Cheryl Chapin, Robert Tepper, Dara G Torgerson and 1 more

Abstract read
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Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Philip L BallardDepartment of Pediatrics, University of California, San Francisco, CA, USA. Phil.ballard@ucsf.edu.
Kelvin D MacDonaldDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.
Julia HarrisDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.
Thaybeth I Malave-MendezPharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California, San Francisco, CA, USA.
Mitzi GoDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.
Alec MartinDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.
Kristin MilnerDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.
Cheryl ChapinDepartment of Pediatrics, University of California, San Francisco, CA, USA.
Robert TepperDepartment of Pediatrics, University of Indiana School of Medicine, Indianapolis, IN, USA.
Dara G TorgersonEpidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Cindy T McEvoyDepartment of Pediatrics, University of Oregon Health and Science University, Portland, OR, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtending the duration of continuous positive airway pressure (CPAP) in preterm infants with respiratory distress may improve lung function.

objectiveAssess the impact of extended CPAP (eCPAP) on the metabolomic profile and relationship to lung function. DESIGN/

methodsInfants ≤32 weeks' gestational age were randomized to bubble eCPAP with room air or discontinued CPAP (dCPAP). Functional residual capacity (FRC) was measured at randomization and at 2 weeks. Blood samples obtained during treatment were subjected to UHPLC:MS/MS (Metabolon Inc.) and metabolomic data were analyzed by ANCOVA.

resultseCPAP infants had greater increases in both FRC (2.1-fold, p = 0.005) and weight (1.13-fold, p = 0.03). Of 1230 total metabolites detected, levels of 87 were higher at p < 0.05 and 75 were lower in eCPAP infants. A new plateau level for key metabolites occurred at 5 ± 2 days after discontinuing CPAP. Sub pathway enrichment (p < 0.05) occurred for bilirubin degradation products (7.7-fold) and acylcarnitines (3.5-fold), all higher in dCPAP. Blood levels of some metabolites were correlated with FRC and weight gain.

conclusionDiscontinuation of CPAP altered the blood metabolome and impaired gain in FRC and weight. Extending CPAP may reduce the work of breathing, improve mitochondrial utilization of fatty acids, and provide more energy for lung and body growth. IMPACT: Discontinuing CPAP in premature infants recovering from respiratory distress altered levels of 14% of detected blood metabolites within 1 week and reduced gain in lung function and body weight at 2 weeks. Biochemical sub pathway enrichment occurred for acylcarnitines with higher circulating levels of 22 fatty acid metabolites in infants coming off CPAP. Extending CPAP beyond the current guidelines for discontinuation may reduce the work of breathing, improve mitochondrial utilization of fatty acids, and provide more energy for lung development and body growth.

Identifiers

PMID41429951

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.