[Nasal continuous positive airway pressure in preterm infants: comparison of two low-resistance models].
OBJECTIVE
To compare the safety and efficacy of two low expiratory resistance models of nasal continuous positive airway pressure (n-CPAP) in preterm infants.


METHODS
A 1-year prospective trial was performed in the Neonatal Intensive Care Unit of La Fe Hospital to compare the Infant Flow (IF) and Medijet (MJ) devices. All preterm infants requiring n-CPAP for respiratory distress at birth (group I), infants weighting less than 1500 g requiring postextubation (group II) and those with apnea-bradycardia syndrome (ABS) (group III) were included. The patients were randomly assigned to IF or MJ.


RESULTS
A total of 125 patients received 226 treatments (IF: n 5 126: MJ: n 5 110). The mean gestational age was 29.4 weeks and the mean birth weight was 1340 g.Efficacy. In group I (n 5 73) no difference were found between systems and 6 hours' after initiation of n-CPAP decreases in FiO2, CO2 and respiratory effort were similar. The need for intubation was also similar (IF: 34.6 %; MJ: 24.1 %). In group II (n 5 73) the need for reintubation at 48 hours was similar with both treatments (IF:19 %; MJ: 8 %). In group III (n 5 80) resolution of ABS was similar after 24 hours of n-CPAP (IF: 46 %; MJ: 58 %). The need for intubation was also similar (IF: 26 %; MJ: 10 %).Complications. Air leaks occurred in six preterm infants (IF: 4; MJ: 2). Severe abdominal distension occurred in 5 % with both systems. Five infants had significant nasal lesions (IF: 1; MJ: 4).


CONCLUSIONS
The efficacy and safety of both systems was similar in the variables studied and no significant differences were found.
Gutiérrez Laso
A
A
Unidad de Cuidados Intensivos. Servicio de Neonatología. Hospital Universitario La Fe. Valencia. España. aguti@teleline.es
Sáenz González
P
P
Izquierdo Macián
I
I
Fernández Gilino
C
C
Gimeno Navarro
A
A
Gormaz Moreno
M
M
Torres Palomares
D
D
Morcillo Sopena
F
F
Roqués Serradilla
V
V
D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D016896:Treatment Outcome