Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome

Abstract

Among preterm infants with suspected RDS, early use of NIPPV reduces the need for intubation and mechanical ventilation compared to CPAP.

Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

“…9 During the study period, whether in the nIPPV or nCPAP method, the occurrence of side effects was not observed, similar to that noted by other authors. 1,6,7,11,19 Barrington et al and Davis et al were unanimous in affirming that nIPPV is a useful and effective method to increase the benefits of nCPAP in the prevention of extubation failure of premature infants in the first hours after extubation. 1, 8 Likewise, Khalaf et al consider nIPPV as more effective than nCPAP in the weaning of premature infants with respiratory distress syndrome (RDS) using mechanical ventilation, and recommend that nIPPV should be used as the primary extubation method even in premature infants with impaired pulmonary function.…”

“…Kishore et al believe that with nIPPV there is better alveolar recruitment, with improved residual functional capacity. 11 Moretti et al consider that nIPPV may increase upper airway patency by creating high pressure in the pharynx and promoting intermittent inflation of the pharynx, thereby activating the respiratory rhythm. 22 In their study, the authors performed pulmonary function tests and found that during nIPPV the pulmonary volumes (tidal volume and minute volume) were significantly higher compared to nCPAP, and the values of the transcutaneous PaCO 2 were also significantly lower compared to those in the nCPAP group.…”

“…This ventilation method seems to ensure better respiratory support, particularly in premature infants with VLBW, decreasing the need for tracheal re-intubation. 1, 10,11 Although there are few studies on the use of nIPPV, most research consists of a small number of newborns and/or observation for a short period after extubation. 1,7,12 Method Sample Seventy-two newborns were studied, all with a GA ≤ 36 weeks and 6 days and BW > 750 g, and respiratory failure requiring orotracheal intubation and mechanical ventilation at the Unidade de Cuidados Intensivos Neonatal, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP) and the Unidade de Terapia Intensiva Neonatal, Hospital Estadual Mário Covas de Santo André (UTIN HESA).…”

Nasal intermittent positive pressure ventilation in the newborn: review of literature and evidence-based guidelines

“…A recent study that used our SNIPPV guidelines 19 for NIPPV has also reported benefit. 20 A detailed description of the equipment and technique in providing (S)NIPPV, as practiced by our group, has been included in the Appendix.…”

Extubações acidentais - será que os bebês estão tentando nos dizer alguma coisa?

“…12 Primary mode SNIPPV (after early intubation and surfactant administration), in a RCT, had a significantly improved primary outcome of BPD/death, compared to the group that continued on ETT IPPV, with no difference in other common neonatal morbidities. 18 In a RCT using primary mode NIPPV (using NIPPV as first line of therapy), the infants randomized to the NIPPV group were more likely to stay extubated 13,14 and had less BPD. 13 In another RCT, primary mode NIPPV (after early intubation and surfactant administration) resulted in more successful extubation and less BPD.…”