A Review on Non-invasive Respiratory Support for Management of Respiratory Distress in Extremely Preterm Infants

Shi, Yuan; Muniraman, Hemananda; Biniwale, Manoj; Ramanathan, Rangasamy

doi:10.3389/fped.2020.00270

Cited by 66 publications

(69 citation statements)

References 108 publications

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“…The main indications are obstructive sleep apnea syndrome, restrictive lung diseases, apnea of prematurity, acute and chronic respiratory failure, etc. [1,4,21,22]. However, there are few studies on the application of NIV in infants who underwent cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Infants with congenital heart disease (CHD) need respiratory support after surgery because of their young age and poor independent mobility. Noninvasive ventilation (NIV) has been proven to be useful for respiratory support in pediatric patients and can effectively reduce the extubation failure rate in high-risk infants [1][2][3][4][5]. In recent years, the technique of NIV has become increasingly mature, especially the application of bilevel positive airway pressure (BiPAP) and nasal continuous positive airway pressure (NCPAP), which have signi cantly reduced the application of invasive ventilation and shortened the time of mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Bilevel Positive Airway Pressure Versus Nasal Continuous Positive Airway Pressure for Prevention of Extubation Failure in Infants After Cardiac Surgery: A Randomized Controlled Trial

Zheng

Xie

liu

et al. 2021

Preprint

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Objective: To evaluate the effect of bilevel positive airway pressure (BiPAP) and nasal continuous positive airway pressure (NCPAP) in respiratory support after extubation in infants undergoing cardiac surgery. Methods: A total of 83 infants who underwent repair of atrial septal defect (ASD) or ventricular septal defect (VSD) after extubation were randomized to the BiPAP group (n= 42) or the NCPAP group (n= 41) between January 2020 and December 2020. The primary outcomes were the extubation failure rate and the level of PCO2 within 24 h after extubation. Results: The baseline characteristics between the two groups were similar. The introduction of BiPAP for post-extubation respiratory support did not reduce extubation failure rates compared to NCPAP (P>0.05). The PaCO2 level within 48 h was significantly lower in the BiPAP group (P<0.05). Additionally, the PaO2/FiO2 in the BiPAP group was significantly higher than that in the NCPAP group at 6h, 12h and 24h after treatment (P<0.05).There were no statistically significant differences in duaration on NIV, hospital length of stay, total hospital costs in $ and complications between the two groups (P>0.05). Conclusion: The introduction of BiPAP for post-extubation respiratory support did not reduce extubation failure rates versus NCPAP. However, BiPAP was shown to be superior to NCPAP in improving oxygenation and carbon dioxide clearance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bilevel Positive Airway Pressure Versus Nasal Continuous Positive Airway Pressure for Prevention of Extubation Failure in Infants After Cardiac Surgery: A Randomized Controlled Trial

Zheng

Xie

liu

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The required support varies depending on the type of nasal interface used. Higher settings might be necessary, as recommended by other investigators [ 15 ]. Non-invasive ventilation can be administered through a variety of nasal interfaces, short, bi-nasal prongs are recommended [ 60 ], but there have been no trials demonstrating the superiority of one interface over the other in decreasing BPD [ 61 ].…”

Section: Nasal Intermittent Positive Pressure Ventilationmentioning

confidence: 99%

“…Early use of non-invasive ventilation minimizes the risk for lung injury and decreases the risk of BPD compared to invasive mechanical ventilation [ 13 , 14 ]. Once limited to the use of NCPAP, clinicians now have access to a wide array of multiple non-invasive ventilator strategies [ 15 ]. The current review aims to summarize the available evidence on the use of different non-invasive ventilation techniques, specifically to decrease BPD.…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Ventilatory Strategies to Decrease Bronchopulmonary Dysplasia—Where Are We in 2021?

Dumpa

Bhandari

2021

Children

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Recent advances in neonatology have led to the increased survival of extremely low-birth weight infants. However, the incidence of bronchopulmonary dysplasia (BPD) has not improved proportionally, partly due to increased survival of extremely premature infants born at the late-canalicular stage of lung development. Due to minimal surfactant production at this stage, these infants are at risk for severe respiratory distress syndrome, needing prolonged ventilation. While the etiology of BPD is multifactorial with antenatal, postnatal, and genetic factors playing a role, ventilator-induced lung injury is a major, potentially modifiable, risk factor implicated in its causation. Infants with BPD are at a higher risk of developing complications including sepsis, pulmonary arterial hypertension, respiratory failure, and death. Long-term problems include increased risk of hospital readmissions, respiratory infections, and asthma-like symptoms during infancy and childhood. Survivors who have BPD are also at increased risk of poor neurodevelopmental outcomes. While the ultimate solution for avoiding BPD lies in the prevention of preterm births, strategies to decrease its incidence are the need of the hour. It is time to focus on gentler modes of ventilation and the use of less invasive surfactant administration techniques to mitigate lung injury, thereby potentially decreasing the burden of BPD. In this article, we discuss the use of non-invasive ventilation in premature infants, with an emphasis on studies showing an effect on BPD with different modes of non-invasive ventilation. Practical considerations in the use of nasal intermittent positive pressure ventilation are also discussed, considering the significant heterogeneity in clinical practices and management strategies in its use.

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“…3 Current management strategies suggest avoidance of invasive mechanical ventilation because time on mechanical ventilation is associated with an increased risk of developing bronchopulmonary dysplasia, neurological dysfunction, and worse overall neurodevelopment. 4 Infants with lower gestational age are more likely to require surfactant administration and invasive mechanical ventilation. 3 The challenge of mechanical ventilation in premature infants, as in other patient populations, is balancing the risk of ventilator-induced lung injury while providing adequate gas exchange.…”

mentioning

confidence: 99%

Unsolved Mysteries: High-Frequency Jet Ventilation in the Neonatal ICU

Miller

Bartle

2020

Respir Care

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A Review on Non-invasive Respiratory Support for Management of Respiratory Distress in Extremely Preterm Infants

Cited by 66 publications

References 108 publications

Bilevel Positive Airway Pressure Versus Nasal Continuous Positive Airway Pressure for Prevention of Extubation Failure in Infants After Cardiac Surgery: A Randomized Controlled Trial

Bilevel Positive Airway Pressure Versus Nasal Continuous Positive Airway Pressure for Prevention of Extubation Failure in Infants After Cardiac Surgery: A Randomized Controlled Trial

Non-Invasive Ventilatory Strategies to Decrease Bronchopulmonary Dysplasia—Where Are We in 2021?

Unsolved Mysteries: High-Frequency Jet Ventilation in the Neonatal ICU

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