Non-synchronized nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) after extubation in preterm infants with respiratory distress syndrome

Abstract

INTRODUCTION: To determine whether non-synchronized nasal intermittent positive pressure ventilation (NIPPV) reduces extubation failure, compared to nasal continuous positive airway pressure (NCPAP), in preterm infants with respiratory distress syndrome (RDS). METHODS: This retrospecti̇ve study included a total of 49 premature infants who were <32 weeks gestation with a birth weight of <1,500 g and required intubation due to RDS. The patients were followed up either to NIPPV or NCPAP after extubation. The primary outcome was extubation failure within 48 h of extubation, while the secondary outcome was neonatal morbidities. RESULTS: A total of 23 patients received NCPAP and 26 patients received NIPPV following extubation. Baseline characteristics were similar in both NCPAP and NIPPV groups. Extubation failure was observed in five (21.7%) NCPAP patients and in nine (34.6%) NIPPV patients, although it did not reach statistical significance (p=0.32). There were no significant differences in the rate of post-extubation atelectasis and pneumothorax. There was no significant differences in the rates of other neonatal morbidities and death between the groups, although the incidence of patent ductus arteriosus was statistically higher in the NIPPV group (p<0.05). None of the patients had gastric or intestinal perforation. DISCUSSION AND CONCLUSION: NIPPV is not superior to NCPAP in preterm infants after extubation in reducing the incidence of reintubation and respiratory morbidities, including pneumothorax and post-extubation atelectasis.

Keywords

• extubation failure
• ncpap
• nippv
• respiratory distress syndrome
• preterm infants