COIN is CPAP Or INtubation at birth for babies born at 25+0 – 28+6 weeks’ gestation.
There was no significant difference in the combined outcome of death or BPD at 36/40.
In the CPAP group, there were fewer days of assisted ventilation and a lower risk of death or need for O2 at 28 days (64.4% vs 75.6%, OR 0.58 (0.41-0.83)). This is more significant in those born 27 – 28+6 weeks gestation. On the contrary, the pneumothorax rate was higher in the CPAP group (9.3% vs 3%, p=0.001).
Reference: Morley CJ, Davis PG, Doyle LW et al. ‘Nasal CPAP or Intubation at Birth for Very Preterm Infants.’ N Engl J Med 2008; 358:700-708. DOI: 10.1056/NEJMoa072788. Multicentre RCT. 610 infants.
Previously published: 09/09/14