• Hesham Abdel-Hady, Basma Shouman, and Nehad Nasef.
• Neonatal Intensive Care Unit, Mansoura University Children's Hospital, Mansoura, Egypt, hehady@yahoo.com.
• World J Pediatr. 2015 Aug 1; 11 (3): 212-8.

BackgroundNasal continuous positive airway pressure (NCPAP) is frequently used in preterm infants. However, there is no consensus on when and how to wean them from NCPAP.Data SourcesBased on recent publications, we have reviewed the criteria of readiness-to-wean and factors affecting weaning success. A special focus is placed on the methods of weaning from NCPAP in preterm infants.ResultsPractical points of when and how to wean from NCPAP in preterm infants are explained. Preterm infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no (or minimal) oxygen requirement. Methods used to wean from NCPAP include: sudden weaning of NCPAP, gradual decrease of NCPAP pressure, graded-timeoff NCPAP (cycling), weaning to high or low flow nasal cannula, and a combination of these methods. The best strategy for weaning is yet to be determined. Cyclingoff NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of weaning. Gradual decrease of NCPAP pressure is more physiological and better tolerated than cycling-off NCPAP.ConclusionFurther studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.

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