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In this episode of The Incubator Podcast, Dr. Guilherme Sant’Anna, Professor of Pediatrics at McGill University, joins Ben and Daphna to discuss his team’s work on implementing an early bubble CPAP protocol in the delivery room. Although CPAP has long been considered standard practice for preterm infants, Dr. Sant’Anna explains why intubation rates remain high in the most immature babies and how his group sought to change this pattern.

The conversation reviews the background of the protocol, which began at McGill in 2014, and the cultural shift required to adopt bubble CPAP as the default approach. Dr. Sant’Anna describes the importance of multidisciplinary training, technical details such as proper prong sizing, fixation, humidification, and suctioning, as well as the challenges of sustaining practice change over a decade.

The results of this initiative are striking: lower rates of delivery room intubation, reduced severe BPD, and improvements in outcomes particularly for infants born before 28 weeks. Dr. Sant’Anna also reflects on lessons learned, the global implications of bubble CPAP in resource-limited settings, and the importance of sharing knowledge to improve care everywhere.

This episode highlights how attention to detail, persistence, and team culture can transform neonatal respiratory care.

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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