Effects of nasal intermittent positive pressure ventilation compared with continuous positive airway pressure for respiratory distress syndrome in low birth weight preterm infants
10.3760/cma.j.issn.1007-9408.2015.02.006
- VernacularTitle:经鼻间歇与鼻塞式持续正压通气治疗早产低出生体重儿呼吸窘迫综合征
- Author:
Jia CHEN
;
Weiwei GAO
;
Chuan NIE
;
Fang XU
;
Lanlan DU
;
Shu LIANG
;
Jie YANG
- Publication Type:Journal Article
- Keywords:
Respiratory distress syndrome,new born;
Intermittent positive-prcssurc vcntilation;
Continuous positive airway pressure;
Infant,low birth weight;
Infant premature
- From:
Chinese Journal of Perinatal Medicine
2015;18(2):111-116
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of early nasal intermittent positive pressure ventilation (NIPPV) compared with early continuous positive airway pressure (NCPAP) in low birth weight preterm infants with respiratory distress syndrome (RDS).Methods We performed a prospective,randomized controlled trial involving 364 low birth weight preterm infants with respiratory distress syndrome within 6 hours of birth.The infants were randomly assigned to NIPPV (n=188) or NCPAP (n=176) groups.Non invasive ventilation was initiated in the neonatal intensive care unit (NICU).The rate of mechanical intubation (within 3 days or 7 days),the use of pulmonary surfactant (PS),the rate of complications and mortality were compared between the two groups.Mann Whitney U,t and Chi-square tests were used for statistical analysis.Results The average time of invasive mechanical ventilation in NIPPV group were lower than that in NCPAP group[2.0 (1.0-4.0) d vs 7.0 (3.0-8.5) d,U=-3.457,P=0.001].The need for intubation and mechanical ventilation by day 3 and day 7 in the NIPPV group were less than those in the NCPAP group [day 3:4.8％ (9/188) vs 10.8％ (19/176),x2=4.621,P=0.032; day 7:9.0％ (17/188) vs 16.5％ (29/176),x2=4.551,P=0.033].In the NIPPV group,infants who got PS therapy was less than that in the NCPAP group [3.2％ (6/188) vs 8.5％ (15/176),x2=4.752,P=0.029].There was no significant difference in the fatality rate between the NIPPV and the NCPAP group [12.8％ (24/188) vs 10.8％ (19/176),P ＞ 0.05].There were no significant difference in the incidence of air leak,intracranial hemorrhage,periventricular leukomalacia,retinopathy of prematurity,necrotizing enterocolitis,patent ductus arteriosus,and bronchopulmonary dysplasia between the NIPPV group and the NCPAP group.Conclusion Among low birth weight prcterm infants with RDS,the early use of NIPPV reduces the need for PS,intubation and invasive ventilation compared with NCPAP.
