Neonatal nasal intermittent positive pressure ventilation: what do we know in 2007?

Owen, Louise; Morley, Colin J; Davis, Peter G

doi:10.1136/adc.2007.117614

Cited by 48 publications

(33 citation statements)

References 66 publications

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“…Atualmente observa-se o aumento no interesse científico e clínico pelo tipo de suporte não invasivo denominado de ventilação por pressão positiva intermitente nasal (VPPIN) [5][6][7] . Esta modalidade de ventilação é conceituada como o método de fornecimento de pressão positiva sem a necessidade de utilização de tubo intratraqueal ou traqueostomia, na qual é proporcionado suporte inspiratório de forma intermitente e não invasiva, com nível de pressão positiva inspiratória maior que a expiratória 8 .…”

Section: Introductionunclassified

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Medeiros¹,

Carvalho²,

Soriano³

2012

J Pediatr (Rio J)

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Objective: To investigate the use of nasal intermittent positive pressure ventilation (NIPPV) in level three neonatal intensive care units (NICU) in northeastern Brazil. Methods:This observational cross-sectional survey was conducted from March 2009 to January 2010 in all level three NICUs in northeastern Brazil that are registered in the Brazilian Registry of Health Establishments (Cadastro Nacional de Estabelecimentos de Saúde, CNES) of the Ministry of Health. Questionnaires about the use of NIPPV were sent to the NICU directors in each institution. Statistical analysis was conducted using the software Epi-Info 6.04 and double data entry. A chi-square test was used to compare variables, and the level of statistical significance was set at p ≤ 0.05. Results: This study identified 93 level three NICUs in northeasternBrazil registered in CNES, and 87% answered the study questionnaire. ResumoObjetivo: Conhecer as práticas referentes ao uso de ventilação por pressão positiva intermitente nasal (VPPIN) em unidades terciárias de atendimento neonatal do Nordeste brasileiro.Métodos: Estudo observacional seccional tipo inquérito, realizado entre março de 2009 e janeiro de 2010 em todas as instituições de atendimento neonatal de nível terciário localizadas no Nordeste brasileiro, cadastradas no Conselho Nacional dos Estabelecimentos de Saúde (CNES) do Ministério de Saúde. Realizado por meio de levantamento, utilizando questionários sobre o uso de VPPIN, enviados aos responsáveis das unidades de cuidados intensivos neonatais de cada instituição. A análise estatística foi realizada pelo software Epi-Info versão 6.04, com dupla entrada de dados. As variáveis foram comparadas pelo teste do qui-quadrado, sendo considerado nível de significância de 5%.Resultados: Estão cadastradas no CNES 93 unidades terciárias neonatais no Nordeste brasileiro. Os questionários foram respondidos por 87% delas. A maior parte classificou-se como de natureza privada (30,7%) ou pública estadual (29,4%). O número de instituições que se utilizam da VPPIN correspondeu a 98,7% do total. Grande parte das unidades (92,8 %) declarou utilizar aparelhos de ventilação pulmonar mecânica, adaptados para aplicação de VPPIN, e pronga binasal curta como interface (94,2%). O protocolo para aplicação de VPPIN existia em apenas 17,3% das unidades. A média dos valores de pressão positiva inspiratória adotados foi de 20,0 cmH 2 O (desvio padrão = 4,47) e de pressão expiratória final positiva foi de 5,0 cmH 2 O (desvio padrão = 0,84). Conclusão:A VPPIN representa um suporte utilizado pelas unidades neonatais no Nordeste brasileiro, embora se observe pouca uniformização quanto às indicações e parâmetros adotados entre as instituições. J Pediatr (Rio J). 2012;88(1):48-53:Respiração artificial, neonatologia, unidade de terapia intensiva, recém-nascido. Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

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Section: Introductionunclassified

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Medeiros¹,

Carvalho²,

Soriano³

2012

J Pediatr (Rio J)

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“…NIPPV ϭ nasal intermittent positive-pressure ventilation and in the need for invasive ventilation for the preterm infant. [1][2][3][4][5][6]17,18 In the present study, a significant association was observed between NIV failure and the absence of intermittent positive pressure (P ϭ .02, odds ratio 1.22). Only 30% (n ϭ 12) of the infants treated with NIPPV failed this modality.…”

Section: Discussionmentioning

confidence: 52%

Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation

Silveira

Leonardi²,

Melo³

et al. 2015

Respir Care

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BACKGROUND: Noninvasive ventilation (NIV) in preterm infants is currently applied using intermittent positive pressure (2 positive-pressure levels) or in a conventional manner (one pressure level). However, there are no studies in the literature comparing the chances of failure of these NIV methods. The aim of this study was to evaluate the occurrence of failure of 2 noninvasive ventilatory support systems in preterm neonates over a period of 48 h. METHODS: A randomized, prospective, clinical study was conducted on 80 newborns (gestational age < 37 weeks, birthweight < 2,500 g). The infants were randomized into 2 groups: 40 infants were treated with nasal CPAP and 40 infants with nasal intermittent positive-pressure ventilation (NIPPV). The occurrence of apnea, progression of respiratory distress, nose bleeding, and agitation was defined as ventilation failure. The need for intubation and re-intubation after failure was also observed. RESULTS: There were no significant differences in birth characteristics between groups. Ventilatory support failure was observed in 25 (62.5%) newborns treated with nasal CPAP and in 12 (30%) newborns treated with NIPPV, indicating an association between NIV failure and the absence of intermittent positive pressure (odds ratio [OR] 1.22, P < .05). Apnea (32.5%) was the main reason for nasal CPAP failure. After failure, 25% (OR 0.33) of the newborns receiving nasal CPAP and 12.5% (OR 0.14) receiving NIPPV required invasive mechanical ventilation. CONCLUSIONS: Ventilatory support failure was significantly more frequent when nasal CPAP was used.

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“…Therefore, the use of synchronization is an important issue that needs additional investigation. 18 In the United Kingdom, given the widespread use of (S)NIPPV, not surprisingly, a wide variety of ventilator settings have been used. 6 One would anticipate a similar scenario in the units in USA using this technique.…”

Section: Techniquementioning

confidence: 99%

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

Bhandari

2009

J Perinatol

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Neonatal nasal intermittent positive pressure ventilation: what do we know in 2007?

Cited by 48 publications

References 66 publications

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation

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

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