Abstract
Background and aims: Nasal intermittent positive pressure ventilation (N-SIPPV) can constitute a new ventilatory mode for RDS treatment. In this regard, N-SIPPV has been shown to be safe and more effective than N-CPAP when used in the weaning from MV. However, data comparing the effectiveness of N-CPAP versus N-SIPPV as best first intention therapeutic strategy for RDS treatment of ELBW/VLBW infants are to date lacking. The present study investigates whether first intention N-CPAP or N-SIPPV can constitute a valid option of ventilation in the respiratory management of RDS.
Methods: From January 2005 to January 2009 we performed a prospective case-control study in 92 infants (< 32 wks) complicated by RDS of whom 23 cases were supported by N-SIPPV and matched for gestational age and weight at birth with 69 VLBW newborns supported by N-CPAP (1 N-SIPPV vs 3 N-CPAP). The effectiveness of the two ventilatory strategies was evaluated by primary (failure of respiratory support, death in the first week) and secondary (length of respiratory support and of staying in hospital; incidence of air leak, sepsis, PDA, NEC, IVH, PVL, ROP, PPHN, CLD; need of post-natal glucocorticoids) end-points.
Results: No significant differences in primary and secondary end-points (P>0.05, for all) have been shown in the two different ventilatory strategies. However, the length of nasal ventilation support was higher in N-SIPPV group, although not statistically significant (P>0.05).
Conclusions: The present data provide evidence that first intention non-invasive ventilatory strategy could be successful in ELBW/VLBW infants undependently form N-SIPPV and/or N-CPAP devices.
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Ricotti, A., Crivelli, S., Temporini, F. et al. 516 First Intention N-Sippv Vs. N-Cpap in Preterm Infants Complicated by Respiratory Distress Syndrome. Pediatr Res 68 (Suppl 1), 264 (2010). https://doi.org/10.1203/00006450-201011001-00516
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DOI: https://doi.org/10.1203/00006450-201011001-00516
