Nasal CPAP for Very Preterm Infants

To the Editor: In the trial reported by Morley et al. (Feb. 14 issue), 1 a significant reduction in the use of surfactant in the group treated with early continuous positive airway pressure (CPAP) as compared with the intubation group (38% vs. 77%) was perhaps the most striking finding. In the CPAP group, the median time for intubation was 6.6 hours (interquartile range, 2.2 to 19.3), and we inferred from this that surfactant was probably given as a rescue treatment. Since the timing of surfactant therapy is likely to affect outcome measures, 2 perhaps the advantages of early CPAP balanced out the . . .