AI Article Synopsis
- The study evaluates the effectiveness of nasal intermittent positive-pressure ventilation (NIPPV) in infants with respiratory distress syndrome who initially failed nasal continuous positive airway pressure (NCPAP).
- Out of 156 preterm infants, 54.5% successfully transitioned to NIPPV, leading to lower rates of complications like bronchopulmonary dysplasia and better overall survival compared to those who failed NIPPV.
- Key factors for NIPPV failure included lower birth weight and the need for surfactant, suggesting that NIPPV can be a beneficial rescue therapy to limit the need for invasive mechanical ventilation.
Article Abstract
Objective: Evaluate whether nasal intermittent positive-pressure ventilation (NIPPV) as rescue therapy after initial nasal continuous positive airway (NCPAP) failure reduces need for invasive mechanical ventilation (IMV) in infants with respiratory distress syndrome (RDS).
Design: Retrospective cohort involving 156 preterm infants who failed initial NCPAP and were then submitted to NIPPV rescue therapy and classified into NIPPV success or failure, according to need for IMV.
Result: Of all infants included, 85 (54.5%) were successfully rescued with NIPPV while 71 (45.5%) failed. The NIPPV success group had significantly lower rates of bronchopulmonary dysplasia, peri/intraventricular hemorrhage, patent ductus arteriosus and greater survival without morbidities (all p ≤ 0.01). Infants who failed NIPPV had earlier initial NCPAP failure (p = 0.09). In final logistic regression model, birthweight ≤1000 g and need for surfactant remained significant factors for NIPPV failure.
Conclusion: NIPPV rescue therapy reduced the need for IMV in infants that failed NCPAP and was associated with better outcomes.
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| http://dx.doi.org/10.1038/s41372-023-01600-z | DOI Listing |
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