1. Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation.
- Author
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Salum Thomé Silveira, Carmen, Leonardi, Kamila Maia, Carvalho Freire Melo, Ana Paula, Zaia, José Eduardo, and Andrade Brunherotti, Marisa Afonso
- Subjects
HOSPITALS ,ARTIFICIAL respiration ,CHI-squared test ,CONFIDENCE intervals ,PREMATURE infants ,INTERMITTENT positive pressure breathing ,INTUBATION ,LONGITUDINAL method ,NEONATAL intensive care ,PROBABILITY theory ,RESPIRATORY distress syndrome ,NEONATAL intensive care units ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment ,CONTINUOUS positive airway pressure ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,CHILDREN - Abstract
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 reintubation 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. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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