2012 OPEN FORUM Abstracts
NON INVASIVE VENTILATION IN PRETERM NEONATES- NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE VERSUS NASAL INTERMITTENT POSITIVE PRESSURE VENTILATION- A RANDOMIZED CONTROL TRIAL.
Tisha A. Skariah1, Dr. Leslie Lewis2; 1respiratory therapy, Manipal College of Allieied Health Science, Kottayam, India; 2Neonatology, Pediastrics, Kasturba medical College, Udupi, India
Background The use of non invasive ventilation (NIV) in preterm neonates have increased in the past few decades, the main objective being to reduce the exposure to invasive ventilation. It proves to be safe and effective but the best option is yet to be determined. The objective was to determine, if nasal intermittent positive-pressure ventilation (NIPPV) compared with nasal continuous positive airway pressure (NCPAP) decreases the need for mechanical ventilation in first 48 hours when given as a primary respiratory support or post extubation respiratory support in preterm neonates. Method In this single-center, randomized controlled trial, preterm neonates (gestational ages 28-36 weeks) with respiratory distress were randomly assigned to receive NIPPV or NCPAP either as the primary mode of respiratory support or post extubation respiratory support. The primary outcome was the need for mechanical ventilation within the first 48 hours of life. Results A total of 49 neonates were randomly assigned in the early NIV group and a total of 32 neonates in post extubation NIV group after stratification to gestational age of 28-32 weeks and 33-36 weeks. The primary outcome did not differ in early NIIPV (19.2%) and early NCPAP (21.7%) groups. Similarly, the primary outcome in post extubation NIV in both NIPPV (11.1%) and NCPAP (7.1%) did not differ. The complications associated with these modes were also compared and analyzed. There was no difference noted. Conclusion - NIPPV did not decrease the need for mechanical ventilation compared with NCPAP, overall, in the first 48 hours of support. It could be considered as safe and beneficial as compared to NCPAP. However, further studies are required to assess the potential benefits and complications associated with NIPPV in preterm neonates. Sponsored Research - None