Unsynchronized nasal intermittent positive pressure versus nasal continuous positive airway pressure in preterm infants after extubation

Kahramaner, Zelal; Erdemir, Aydın; Türkoğlu, Ebru; Cosar, Hese; Sütçüoğlu, Sümer; Özer, Esra Arun

doi:10.3109/14767058.2013.846316

Cited by 38 publications

(26 citation statements)

References 20 publications

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“…This study showed no evidence of gastrointestinal effects, nasal injury, pneumothorax, PDA, and ROP, as also demonstrated in other studies. [22][23][24][25] The NCPAP groups showed no occurrence of PIVH, whereas we found PIVH ! grade 3 and 4 in three infants in the NIPPV group, which was not significant (p ¼ 0.105).…”

Section: Discussioncontrasting

confidence: 47%

Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial

et al. 2017

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Objective Our aim was to compare the success of extubation in neonates managed with nonsynchronized intermittent nasal positive-pressure ventilation (nsNIPPV) and two modes of nasal continuous positive airway pressure (NCPAP) after the first extubation. Study Design Randomized controlled clinical trial conducted in the neonatal intensive care unit (NICU) included infants with gestational age ≤ 34 weeks and birth weights (BW) 500 to 1,500 g with a diagnosis of respiratory distress syndrome (RDS), divided into three groups: ventilation with nsNIPPV, bubble-NCPAP, and ventilator-NCPAP. Extubation failure (EF) was defined as occurring within 48 hours after extubation. Results We included 101 newborns: nsNIPPV (n = 36); bubble-NCPAP (n = 32) ventilator-NCPAP (n = 33). Overall, the extubation success rate was 81.2%. There were no skin, gastric, or pulmonary complications related to noninvasive ventilation (NIV) (p = 1). There was no difference between the groups regarding the success/EF (p = 0.4). There was extubation success in 81 (81.2%) cases, and EF occurred in 20 (19.8%), associated with longer invasive mechanical ventilation time (p < 0.001) and development of bronchopulmonary dysplasia (p = 0.04). Conclusion In this trial, three modalities of NIV applied in the success/failure outcomes of extubation avoided reintubation in 80% of infants.

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Section: Discussioncontrasting

confidence: 47%

Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial

et al. 2017

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“…6 Kahramaner et al also concluded that nIPPV has a better effect than nCPAP after extubation of premature infants, as it reduced the occurrence of atelectasis, the need for re-intubation and even the number of deaths. 21 conclusion Although the distribution of the failure frequencies showed a numerically lower failure rate in premature infants treated with nIPPV compared to those undergoing nCPAP, there was no statistically significant difference between the two methods of ventilatory support after extubation.…”

Section: Discussionmentioning

confidence: 69%

“…10 In some studies we verified variable rates in relation to extubation failure, sometimes associated with lower birth weight and gestational age. 1, 15,20,21 As such, we sought to verify if there was a relationship between extubation failure in the two methods and the BW and GA, classification of the premature infant, and the MV time. We found that there was no significant difference between the association of the characteristics described and the methods under study.…”

Section: Discussionmentioning

confidence: 99%

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

Komatsu

Diniz

Ferraro

et al. 2016

Rev. Assoc. Med. Bras.

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Objective:To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV) after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV) and continuous positive airway pressure (nCPAP). Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA) ≤ 36 weeks and birth weight (BW) > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6%) presented extubation failure in comparison to 11 (30.5%) of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

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“…43 A similar study showed a higher prevalence of re-intubation, post-extubation atelectasis, and mortality with premature infants supported with CPAP than with non-synchronized NIV. 44 In a retrospective study that compared synchronized NIV with non-synchronized NIV in a cohort of 200 premature infants, after adjusting for disease severity, there were no differences in the combined outcome of bronchopulmonary dysplasia and death. 45 Based on these findings with non-synchronized NIV, synchrony may not be important for predicting patient outcomes with NIV in premature infants.…”

Section: See the Original Study On Page 1478mentioning

confidence: 92%

The Importance of Synchronization During Neonatal Noninvasive Ventilation

DiBlasi

2018

Respir Care

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Unsynchronized nasal intermittent positive pressure versus nasal continuous positive airway pressure in preterm infants after extubation

Abstract: NIPPV (although non-synchronized and delivered by single nasal prong) had a better effect than NCPAP after extubation of preterm infants on mechanical ventilation in respect to reducing the prevalence of post-extubation atelectasis, re-intubation and also death.

Cited by 38 publications

References 20 publications

Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial

Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial

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

The Importance of Synchronization During Neonatal Noninvasive Ventilation

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