Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants

Lemyre, Brigitte; Deguise, Marc-Olivier; Benson, Paige; Kirpalani, Haresh; Ekhaguere, Osayame A.; Davis, Peter G

doi:10.1002/14651858.cd005384.pub3

Cited by 7 publications

(2 citation statements)

References 91 publications

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“…Zhu et al [26] reported that both nHFOV and NIPPV could lower the risk of reintubation compared with CPAP, while they didn't nd any difference in BPD within those 3 groups. The latest Cochrane Database systemic review pointed out that early NIPPV may reduce the risk of respiratory failure, the need for intubation and the rate of BPD in preterm infants with a gestational age of 28 to 32 weeks [27] . It reminds us that we should continuously optimize our ventilation strategies based on current evidence in order to improve the pulmonary outcomes of VPIs.…”

Section: Discussionmentioning

confidence: 99%

Impact of implementation of 2019 European respiratory distress syndrome guidelines on bronchopulmonary dysplasia in very preterm infants

Yan,

Gong,

Luo

et al. 2024

Preprint

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Objective To evaluate the impact of implementation of 2019 European consensus guidelines on management of respiratory distress syndrome (RDS) on the incidence of bronchopulmonary dysplasia (BPD). Method Retrospectively collect the clinical data of very preterm infants (VPIs) born before 32 gestational weeks from January 1st 2018 to December 31st 2021. VPIs are divided into control group and observation group according to their birth date before or after January 1st 2020 when the implementation of 2019 European RDS guidelines initiated. BPD is considered as primary outcome. The secondary outcomes include death, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC) and extrauterine growth restriction (EUGR). Statistically analyze all the data and compare the general characteristics, ventilation support, medication, nutrition and the outcomes between two groups. Results A total of 593 VPIs were enrolled, including 380 cases in control group and 213 cases in observation group. There were no statistic differences regarding to conception mode, gender ratio, gestational age, birth weight, delivery mode and Apgar score in 5th minute between two groups (p > 0.05). Compared with control group, observation group showed higher rate of antenatal corticosteroid therapy (75.1% vs 65.5%) and lower rate of admission hypothermia (16.0% vs 35.5%) (p < 0.05). The incidence of BPD for the whole cohort was 21.6% (128/593). Overall risks of BPD included birth weight less than 1,000g, gestational age less than 28 weeks, male infants, intensive resuscitation, fetal growth retardation, invasive mechanical ventilation, high fraction of inspired oxygen (FiO2) demand, hypercarbia, sepsis, surfactant demand, long-term sedation, hemodynamically significant patent ductus arteriosus (hsPDA) and extrauterine growth restriction. The improvement of ventilation management included lower rate of invasive ventilation (40.4% vs 50.0%), higher rate of volume guarantee (69.8% vs 15.3%), higher initial positive end expiratory pressure (PEEP) [6 (5, 6) vs 5 (5, 5) cmH2O] and higher rate of nasal intermittent positive pressure ventilation (NIPPV) (36.2% vs 5.6%). Compared with control group, observation group received higher initial dose of pulmonary surfactant [200 (160, 200) vs 170 (130, 200) mg/Kg], shorter antibiotic exposure time [13 (7, 23) vs 17 (9, 33) days], more breast milk (86.4% vs 70.3%) and earlier medication for hsPDA treatment [3 (3, 4) vs 8 (4, 11) days] (p < 0.05). As the primary outcome, the incidence of BPD was significantly decreased (16.9% vs 24.2%) (p < 0.05), along with lower EUGR rate (39.0% vs 59.7%), while there were no statistic differences regarding to other secondary outcomes, including mortality, IVH, PVL, ROP and NEC (p > 0.05). However, in the subgroups of infants less than 28 gestational weeks or infants less than 1,000g, the incidence of BPD was not significantly decreased (p > 0.05). Conclusions After implementation of 2019 European RDS guidelines, the overall incidence of BPD was significantly decreased in VPIs. Continuous quality improvement is still needed in order to decrease the incidence of BPD in smaller infants who are less than 28 gestational weeks or less than 1,000g.

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Section: Discussionmentioning

confidence: 99%

Impact of implementation of 2019 European respiratory distress syndrome guidelines on bronchopulmonary dysplasia in very preterm infants

Yan,

Gong,

Luo

et al. 2024

Preprint

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“…It was also noted that there was a slight decrease in the rate of BPD (RR 0.70, 95% CI 0.52-0.92). 92 However, this may not apply to extremely preterm infants that are most at-risk of BPD. 92 Hence, additional studies are required to evaluate the efficacy of NIPPV in preventing BPD in extreme preterm populations.…”

Section: Early Course: First Week Of Life -Early Nrs Strategies To Re...mentioning

confidence: 99%

Prevalence, Prevention and Management of Bronchopulmonary Dysplasia

Gilfillan,

Mejia,

Bhandari

2024

RRN

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Bronchopulmonary dysplasia (BPD) is a complex pulmonary condition that arises in preterm infants secondary to a constellation of adverse exposures contributing to impaired lung development and repair. In many developed countries, the incidence of BPD continues to rise despite the increasing use of evidence-based therapies and efforts to minimize adverse post-natal exposures. Refinement of perinatal care practices that reduce mortality in the most immature infants is likely contributing to this trend; however, a growing population of survivors with respiratory morbidity significantly burdens individuals and health-care systems. Racial and socioeconomic disparities also result in unequal distribution of morbidity within society. In this review, we will outline trends in the incidence of BPD over the last decade and review important risk factors for adverse pulmonary outcomes. The consequences of BPD for long-term health will be described, followed by a comprehensive summary of evidence-based therapies and potential future treatments that can be applied to reduce the incidence, and the prevalence of BPD.

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Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation

Lemyre

Deguise

Benson

et al. 2023

Cochrane Database of Systematic Reviews

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Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants

Cited by 7 publications

References 91 publications

Impact of implementation of 2019 European respiratory distress syndrome guidelines on bronchopulmonary dysplasia in very preterm infants

Impact of implementation of 2019 European respiratory distress syndrome guidelines on bronchopulmonary dysplasia in very preterm infants

Prevalence, Prevention and Management of Bronchopulmonary Dysplasia

Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation

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