Nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome

Journal Title: Medpulse International Journal of Pediatrics - Year 2019, Vol 10, Issue 2

Abstract

Objective:Primary- To determine among the preterm infants with RDS, whether the use of early Nasal intermittent positive pressure ventilation (NIPPV) versus early Continuous positive pressure ventilation (CPAP) reduces the need for invasive ventilation within first 72 hours.Secondary -To compare the duration of primary non invasive ventilation on respective modes, total duration of oxygentherapy, complication rates of feed intolerance, necrotizing enterocolitis, Intraventricular hemorrhages, nasal trauma, time taken to achieve full feeds and duration of hospital stay.Methods: This is a comparative randomized controlled study, held at inborn NICU, Cheluvamba Hospital, attached to MMC and RI, Mysuru between May and June 2018.Neonates (30-36 weeks gestational age) having RDS within 6 hours of birth were allocated to either CPAP or NIPPV mode.Results: A total of 50 neonates were enrolled in the study (27 to early CPAP and 23 to early NIPPV mode). Failure rate and need for mechanical ventilation within 72 hours was though less in early NIPPV mode, but not statistically significant. (14.4% of NIPPV versus 29.6% of CPAP respectively, p=0.313).The duration of NIPPV/CPAP and incidence of nasal trauma on respective mode was significantly less for NIPPV than CPAP. (Duration- 19.90 hrs versus 32.10 hrs respectively, p=0.000. nasal trauma- 0.0% versus 22.2% respectively, p=0.016). The duration of hospital stay was significantly longer for neonates on CPAP mode.Conclusion: Among preterm infants with RDS with moderate respiratory distress, early use of NIPPV does not decrease the need of mechanical ventilation but reduces the duration of early respiratory support, incidence of nasal trauma and duration of hospital stay as compared to CPAP.

Authors and Affiliations

Pawar Gayatri, M Hamsa, Rudrappa Sudha, K Nagendra

Keywords

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