Nonsynchronized nasal intermittent positive pressure ventilation versus continuous positive airway pressure as a primary mode of respiratory support in neonates (26-40 weeks) admitted in a tertiary care center: A randomized controlled trial.
CPAP
nasal IPPV
neonate
primary mode
respiratory distress
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
08
07
2023
received:
03
04
2023
accepted:
21
07
2023
medline:
23
10
2023
pubmed:
2
8
2023
entrez:
2
8
2023
Statut:
ppublish
Résumé
Continuous positive airway pressure (CPAP) is a standard respiratory care for neonates for last few decades but it too has a high failure rate. Nasal intermittent positive pressure ventilation (NIPPV) is proven to be superior to CPAP in maintaining higher mean airway pressure in neonates with Respiratory Distress Syndrome. The main objective of this study was to compare failure within 72 h of initiation of primary respiratory support between nonsynchronized NIPPV and CPAP in all causes of respiratory distress in newborn infants. Secondarily feed intolerance, Necrotizing enterocolitis (NEC > stage II), hemodynamically significant patent ductus arteriosus, intraventricular hemorrhage (IVH > gradeIII), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), duration of support and mortality were also compared. This was a single center randomized controlled trial. Stratified randomization was done for 216 neonates, based on the gestational age in two subgroups 26-33 weeks and 34-40 weeks whopresented with respiratory distress within 5 days of birth, to receive either NIPPV or CPAP. Primary and secondary outcomes were documented. Statisticalsignificant difference was noted for primary outcome (RR 0.48 [confidence interval = 0.301-0.786], p = 0.003) but not for other secondary outcomes. NIPPV appeared superior in respect to noninvasiveventilation days, BPD occurrence and hospitalization duration. As a primary mode, nonsynchronized NIPPV was more efficacious than CPAP in preventing intubation within 72 h of initiation of respiratory support. Further multicenter studies are warranted to explore the benefits of this respiratory support.
Banques de données
CTRI
['CTRI/2021/02/031121']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3063-3070Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012;39:769-783.
Sinha SK, Donn SM. Fetal-to-neonatal maladaptation. Semi Fetal Neon Med. 2006;11:166-173.
Guha DK. NNF recommended basic perinatal-neonatal nomenclature. Neonatology- Principles and Practice. 1sted. Jaypee Brothers; 1998:131-132.
National Neonatal Perinatal Data (NNPD) Network, Indian Council of Medical Research, National Neonatology Forum (India), 2002-2003. Accessed 16 October 2009.
Finer NN, Carlo WA, Walsh MC, et al. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010;362(21):1970-1979.
Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008;358(7):700-708.
Kugelman A, Feferkorn I, Riskin A, Chistyakov I, Kaufman B, Bader D. Nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure for respiratory distress syndrome: a randomized, controlled, prospective study. J Pediatr. 2007;150(5):521-526.e1.
Sai Sunil Kishore M, Dutta S, Kumar P. Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome. Acta Paediatr (Stockholm). 2009;98:1412-1415.
Armanian AM, Badiee Z, Heidari G, Feizi A, Salehimehr N. Initial treatment of respiratory distress syndrome with nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure: a randomized controlled trial. Int J Prev Med. 2014;5(12):1543-1551.
Oncel MY, Arayici S, Uras N, et al. Nasal continuous positive airway pressure versus nasal intermittent positive-pressure ventilation within the minimally invasive surfactant therapy approach in preterm infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2016;101(4):F323-F328.
Silverman WA, Andersen DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics. 1956;17:1-10.
Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg. 1978;187:1-7.
Wynn Jl, Wong Hr, Shanley Tp, Bizzarro Mj, Saiman L, Polin Ra. Time for a neonatal-specific consensus definition for sepsis. Pedi Crit Care Med. 2014;15(6):523-528.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500gm. J Pediatr. 1978;92:529-534.
Moore TA, Wilson ME. Feeding intolerance: a concept analysis. Advan Neon Care. 2011;11(3):149-154.
Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005;123(7):991-999.
Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163:1723-1729.
Dursun M, Uslu S, Bulbul A, Celik M, Zubarioglu U, Bas EK. Comparison of early nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome. J Trop Pediatr. 2019;65(4):352-360.
Sandri F, Plavka R, Ancora G, et al. Prophylactic or early selective surfactant combined with nCPAP in very preterm infants. Pediatrics. 2010;125:e1402-e1409.
Dunn MS, Kaempf J, de Klerk A, et al. Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics. 2011;128:e1069-e1076.
Chen L, Wang L, Li J, Wang N, Shi Y. Noninvasive ventilation for preterm twin neonates with respiratory distress syndrome: a randomized controlled trial. Sci Rep. 2015;5:14483.
Gharehbaghi MM, Hosseini MB, Eivazi G, Yasrebinia S. Comparing the efficacy of nasal continuous positive airway pressure and nasal intermittent positive pressure ventilation in early management of respiratory distress syndrome in preterm infants. Oman Med J. 2019;34(2):99-104.
Esmaeilnia T, Nayeri F, Taheritafti R, Shariat M, Bijani FM. Comparison of complications and efficacy of NIPPV and nasal CPAP in preterm infants with RDS. Iranian. J Pediatr. 2016;26(2):e2352.
Meneses J, Bhandari V, Guilherme Alves J, Herrmann D. Noninvasive ventilation for respiratory distress syndrome: a randomized controlled trial. Pediatrics. 2011;127(2):300-307.