Recommendations for research

Key recommendations for research

1 Non-invasive ventilation techniques

What is the effectiveness of high-pressure non-invasive positive pressure ventilation (NIPPV) compared with continuous positive airways pressure (CPAP) flow driver as the primary mode of ventilation?

To find out why the committee made the research recommendation on non-invasive ventilation techniques, see rationale and impact.

2 Surfactant

What is the best technique for delivering surfactant in a minimally invasive manner? 

To find out why the committee made the research recommendation on surfactant, see rationale and impact.

3 Diuretics

What is the effectiveness of diuretics compared with placebo in preventing bronchopulmonary dysplasia (BPD) in preterm babies on respiratory support?

To find out why the committee made the research recommendation on diuretics, see rationale and impact.

4 Oxygen monitoring

Does targeting higher oxygen saturations of 92% to 97% in preterm babies lead to improved survival without significant complications?

To find out why the committee made the research recommendation on oxygen monitoring, see rationale and impact.

5 Premedication before intubation

What is the most effective combination of an analgesic with a neuromuscular blocker, or an analgesic with an anaesthetic agent, for premedication in preterm babies requiring elective or semi-elective intubation? 

To find out why the committee made the research recommendation on premedication before intubation, see rationale and impact.

Other recommendations for research

Respiratory support before admission to the neonatal unit

Does CPAP plus prophylactic surfactant, administered by a non-invasive technique in the delivery room, improve outcomes compared with CPAP alone in preterm babies?

Surfactant

What is the optimal dosing regimen of surfactant when delivered in a minimally invasive manner?

Oxygen administration

What is the effectiveness of humidified and non-humidified supplemental low-flow oxygen in preterm babies?

What should be the target oxygen saturation range for preterm babies when using an automated oxygen titration system that creates a normal frequency-saturation curve?

Invasive ventilation techniques

Are there differences in the long-term neurodevelopmental outcomes for preterm babies receiving volume-targeted ventilation (VTV) compared with high-frequency oscillatory ventilation (HFOV) as their primary mode of ventilation?

Corticosteroids

What is the comparative efficacy of hydrocortisone compared with dexamethasone for preventing BPD in preterm babies requiring respiratory support?

Is nebulised budesonide effective compared with placebo in preventing BPD in preterm babies requiring respiratory support?

Diuretics

What is the effectiveness of diuretics compared with placebo in the treatment of BPD in preterm babies on respiratory support?

Caffeine citrate

What is the optimal maintenance dose of caffeine citrate in order to optimise neurodevelopmental outcomes in preterm babies?

Oxygen monitoring

What is the accuracy of pulse oximetry and transcutaneous measurement of partial pressure of oxygen compared with arterial oxygen levels for detecting hyperoxia and hypoxia in preterm babies?

Carbon dioxide monitoring

What is the optimal carbon dioxide target range in preterm babies on non-invasive ventilation at different gestational ages?

Blood pressure

What is the optimal method and frequency of measuring blood pressure for preterm babies requiring respiratory support?

What is the optimal target blood pressure range for preterm babies requiring respiratory support?

Morphine

What is the effectiveness of morphine compared with containment holding for preterm babies receiving respiratory support?

Involving parents and carers

What is the impact of parental involvement as part of Family integrated care (FIC) or the Newborn individualised developmental care and assessment programme (NIDCAP®) on the incidence of BPD and length of hospital stay in preterm babies?

Discharge planning

What is best practice around discharge planning for preterm babies on respiratory support?

  • National Institute for Health and Care Excellence (NICE)