Evaluation of the efficacy of nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) in the preterm babies with respiratory distress syndrome (RDS)

Abstract

Background: Neonatal respiratory distress syndrome (RDS), is an acute lung disease caused by pulmonary surfactant deficiency. RDS is generally due to lung immaturity leading to surfactant deficiency in alveoli of lungs and subsequent collapse during expiration. CPAP overcomes this with application of continuous distending pressure through breathing cycle in spontaneously breathing neonate. Recently NIPPV was supposed to be better modality of treatment for such neonates with RDS. However there is paucity of literature regarding the efficacy of NIPPV versus nasal CPAP in the management of preterm babies with RDS. Objectives: Present study aimed to evaluate the efficacy of NIPPV versus NCPAP in the preterm babies < 34 weeks of gestation. Material & Methods: This study was conducted in the Neonatal Intensive Care Unit of SKIMS from April 2016 to April 2017. Data was analyzed using SPSS.A total of 89 preterm infants less than 34 weeks of gestational age were enrolled in the study over a period of 12 months. Forty nine received NCPAP and forty were in the NIPPV group. Results: Average length of stay in the NICU in NCPAP group was 13.96 ± 6.57 days while as it was 10.85 ± 7.26 days in NIPPV group and the difference was statistically significant (p = 0.037). The mortality was 8.16% (4/49) patients in the NCPAP group and 2.50% (1/40) in the NIPPV group died and the difference was statistically insignificant (p = 0.25). Conclusions: NIPPV not only decreases the need for mechanical ventilation in the first 72 of hours of life in preterm babies but also decreases the duration of NICU and hospital stay and decreases the need for surfactant replacement therapy.

Keywords

• nasal intermittent positive pressure ventilation
• nasal continuous positive airway pressure
• respiratory distress syndrome