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Nasal Intermittent Positive Pressure Ventilation (NIPPV) Vs. Nasal Continuous Positive Airway Pressure (NCPAP) after Less Invasive Surfactant Administration (LISA) in Preterm Infants with Respiratory Distress Syndrome

Document Type : original article

Authors

1 Hamadan University of Medical Sciences

2 Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran

3 hamedan university of medical science

4 Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran.

5 Pediatric department, Hamadan University of Medical Sciences , Hamadan , Iran

6 Department of community medicine, Hamadan University of Medical Science , Hamadan, Iran.

Abstract

Background: There is insufficient evidence supporting the superiority of the Nasal Intermittent Positive-Pressure Ventilation (NIPPV) over the Nasal Continuous Positive Airway Pressure (NCPAP) in initial respiratory support of preterm neonates suffering from the Respiratory Distress Syndrome (RDS). The present study intended to compare the effectiveness of these two approaches in preterm neonates with RDS who receive the Less Invasive Surfactant Administration (LISA).
Methods: The present clinical trial included 95 preterm neonates at the Fatemieh Hospital, Hamadan, Iran, from October 2019 to September 2020, with RDS, admitted to the Neonatal Intensive Care Unit. Sampling was performed using the convenience method. The participants were randomly assigned into two groups that received the NIPPV (n=48) or NCPAP (n=47) as the respiratory support method. Moreover, the neonates received LISA if needed. The groups were compared in the outcomes, such as the need for intubation within 72 hours after birth.
Results: The groups were similar in clinical characteristics at birth. According to our findings, the NIPPV group had a significantly lower rate of need for intubation and invasive mechanical ventilation within 72 hours after birth  compared to the control group (8.3% vs. 27.7%, P=0.014); however, the groups were not significantly different regarding the need for the second dose of surfactant (66% vs. 56.2%, P=0.332), the mean respiratory support duration (6.89±3.20 vs. 6.70±3.71 days, P=0.295), the mean hospital stay (19.52±12.364 vs. 17.40±9.57 days, P=0.591), development of bronchopulmonary dysplasia (4.2% vs. 8.5%, P=0.435), and mortality (6.25% vs. 12.8%, P=0.317).
Conclusion: Compared to NCPAP, the NIPPV could significantly reduce the need for invasive mechanical ventilation within 72 hours after birth in neonates undergoing LISA

Keywords

References
  1. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GH, Halliday HL. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update. Neonatology. 2019; 115(4):432-450.
  2. Shokouhi M, Basiri B, Sabzehei MK, Mahdiankhoo M, Pirdehghan A. Efficacy and complications of humidified high‐flow nasal cannula versus nasal continuous positive airway pressure in neonates with respiratory distress syndrome after surfactant therapy. Iran Red Crescent Med J. 2019; 21(2):e83615
  3. Committee on Fetus and Newborn; American Academy of Pediatrics. Respiratory support in preterm infants at birth. Pediatrics. 2014 Jan; 133(1):171-4. doi: 10.1542/peds.2013-3442. Epub 2013 Dec 30. PMID: 24379228.
  4. Morley C.J, Davis P.G, Doyle L.W, Brion L.P, Hascoet J.M, Carlin J.B. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008; 358(7):700-8.
  5. Finer N.N, Carlo W.A, Walsh M.C, Rich W, Gantz M.G, Laptook A.R, Yoder B.A, Faix RG, Das A, Poole WK, Donovan EF, Newman NS, Ambalavanan N, Frantz ID, Buchter S, Sánchez PJ, Kennedy KA, Laroia N, Poindexter BB, Cotton CM, Van Meurs KP, Duara S, Narendran V, Sood BG, O'Shea TM, Bell EF, Bhandari V, Watterberg KL, Higgins RD. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 2010; 362(21):1970-79.
  6. Schmolzer G.M, Kumar M, Pichler G, Aziz K, O'Reilly M, Cheung P.Y. Non-invasive versus invasive respiratory support in preterm infants at birth: systematic review and meta-analysis. Bmj 2013; 347:f5980.
  7. Kugelman A, Feferkorn I, Riskin A, Chistyakov I, Kaufman B, Bader D. Nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure for respiratory distress syndrome: a randomized, controlled, prospective study. J Pediatr 2007; 150:521–6.
  8. Sai Sunil Kishore M, Dutta S, Kumar P. Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome. Acta Paediatr 2009; 98:1412–15.
  9. Meneses J, Bhandari V, Alves JG, Herrmann D. Noninvasive ventilation for respiratory distress syndrome: a randomized controlled trial. Pediatrics 2011; 127:300–7.
  10. Kanmaz HG, Erdeve O, Canpolat FE, Mutlu B, Dilmen U. Surfactant administration via thin catheter during spontaneous breathing: randomized controlled trial. Pediatrics. 2013; 131(2):e502-e9.
  11. Gopel W, Kribs A, Ziegler A, Laux R, Hoehn T, Wieg C, Siegel J, Avenarius S, Wense A, Vochem M, Groneck P, WellerU, Möller J, Härtel C, Haller S, Roth B, Herting E, Network GN. Avoidance of mechanical ventilation by surfactant treatment of spontaneously breathing preterm infants (AMV): an open-label, randomized, controlled trial. The Lancet. 2011; 378(9803):1627-34.
  12. Ramanathan R, Sekar KC, Rasmussen M, Bhatia J, Soll RF. Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress syndrome in preterm infants< 30 weeks’ gestation: a randomized, controlled trial. Journal of Perinatology. 2012; 32(5):336-43.
  13. Shah V, O’Brien K. NIPPV after surfactant treatment for RDS reduces the need for mechanical ventilation at 7 days of Age and BPD in preterm infants: Interpret results with caution. Journal of clinical neonatology. 2012; 1(3):115.
  14. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163:1723-9.
  15. Oncel MY, Yurttutan S, Erdeve O, et al. Oral paracetamol versus oral ibuprofen in the management of patent ductus arteriosus in preterm infants: a randomized controlled trial. J Pediatr 2014; 164:510–14.
  16. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978;92:529–33.
  17. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg 1978; 187:1–7.
  18. Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus. Screening examination.
  19. Mahmoud R. Effectiveness of Nasal Intermittent Positive Pressure Ventilation versus Nasal Continuous Positive Airway Pressure in Preterm Infants after Less Invasive Surfactant Administration. International Journal of Pediatrics. 2019; 7(1):8915-24.
  20. Oncel MY, Arayici S, Uras N, Alyamac-Dizdar E, Sari FN, Karahan S, Canpolat FE, Oguz SS, Dilmen U. Nasal continuous positive airway pressure versus nasal intermittent positive-pressure ventilation within the minimally invasive surfactant therapy approach in preterm infants: a randomized controlled trial. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2016 Jul 1; 101(4):F323-8.
  21. Shi Y, Tang S, Zhao J, Shen J. A prospective, randomized, controlled study of NIPPV versus nCPAP in preterm and term infants with respiratory distress syndrome. Pediatr Pulmonol 2014; 49:673–8.
  22. Lemyre B, Laughon M, Bose C, Davis PG. Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants. Cochrane Database of Systematic Reviews. 2016(12).
  23. Skariah TA, Lewis LE. Early Nasal Intermittent Positive Pressure Ventilation (NIPPV) versus Nasal Continuous Positive Airway Pressure (NCPAP) for Respiratory Distress Syndrome (RDS) in Infants of 28-36 weeks gestational age: a Randomized Controlled Trial. Iranian Journal of Neonatology. 2019 Jun: 10(2). DOI: 10.22038/ijn.2018.32566.1454.
  24. Gharehbaghi MM, Hosseini MB, Eivazi G, Yasrebinia S. Comparing the Efficacy of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation in Early Management of Respiratory Distress Syndrome in Preterm Infants. Oman Med J. 2019 Mar; 34(2):99-104. doi: 10.5001/omj.2019.20. PMID: 30918602; PMCID: PMC6425044.
  25. Ekhaguere O, Patel S, Kirpalani H. Nasal Intermittent Mandatory Ventilation versus Nasal Continuous Positive Airway Pressure Before and After Invasive Ventilatory Support. Clin Perinatol. 2019 Sep; 46(3):517-536. doi: 10.1016/j.clp.2019.05.004. Epub 2019 Jun 20. PMID: 31345544.
  26. Aghai ZH, Saslow JG, Nakhla T, Milcarek B, Hart J, Lawrysh-Plunkett R Stahl G, Habib RH, Pyon KH. Synchronized nasal intermittent positive pressure ventilation (SNIPPV) decreases work of breathing (WOB) in premature infants with respiratory distress syndrome (RDS) compared to nasal continuous positive airway pressure (NCPAP). Pediatr Pulmonol 2006; 41: 875–881.
  27. Kiciman NM, Andreasson B, Bernstein G, Mannino FL, Rich W, Henderson C Heldt GP. Thoracoabdominal motion in newborns during ventilation delivered by endotracheal tube or nasal prongs. Pediatr Pulmonol 1998; 25: 175–181.
  28. Aldana-Aguirre JC, Pinto M, Featherstone RM, Kumar M. Less invasive surfactant administration versus intubation for surfactant delivery in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2017; 102(1):F17-F23.
  29. Lau CS, Chamberlain RS, Sun S. Less invasive surfactant administration reduces the need for mechanical ventilation in preterm infants: a meta-analysis. Global pediatric health. 2017; 4:2333794X17696683.
  30. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB; COIN Trial Investigators. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008; 358(7):700-8. doi: 10.1056/NEJMoa072788.
  31. Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS. A trial comparing noninvasive ventilation strategies in preterm infants. New England Journal of Medicine. 2013; 369(7):611-20.
International Journal of Pediatrics
Volume 10, Issue 5
May 2022
Pages 15972-15981
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