Studies of apnoea in the newborn: Delivery of positive inflating pressure as early rescue

Premature babies, especially those born before 30 weeks, frequently experience brief pauses in breathing called apnoeas. These episodes can cause the baby's oxygen level to drop and their heart rate to slow, which can be stressful for both the baby and the care team. CPAP (Continuous Positive Airway Pressure) is the standard support used for these babies, but when a breathing pause occurs, nurses or therapists typically need to manually stimulate the baby to restart breathing. This study is testing a device that automatically delivers a short puff of air (called a positive inflation pressure, or PIP) when it detects the baby has stopped breathing for three seconds. The device either gives one puff or up to three puffs. Researchers will compare these approaches to standard CPAP alone in a crossover study — meaning each baby acts as their own control across different four-hour blocks. This study is for very premature babies (born before 30 weeks) who are currently on CPAP and experiencing frequent apnoeic episodes. Babies whose doctors are considering changing their breathing support in the next 24 hours are not eligible. If effective, this device could reduce the number of critical episodes and decrease the need for more invasive breathing support.