Use of nasal intermittent positive pressure ventilation to avoid intubation in neonates.
OBJECTIVE
Nasal intermittent positive pressure ventilation (NIPPV) has widely been used in neonates to prevent extubation failure and apnea. This pilot study was carried out to look at the early use of NIPPV to avoid intubation.


METHODS
The study was carried out over a period of 3 months from August 2003 to October 2003 at the Royal Hospital, Muscat, Sultanate of Oman. The neonates with clinical signs of moderate to severe respiratory distress were given a trial of early NIPPV based on the avoid-intubation protocol. Inclusion, exclusion and failure criteria with general procedure were made clear to all medical and nursing staff and the protocol was posted in the unit for further time to time referral.


RESULTS
A total of 16 neonates met the inclusion criteria for early NIPPV trial. Out of these, 13 (81%) had a successful NIPPV. The mean age of entry was 0.95 hours; however, the mean duration of NIPPV was 23 hours. No NIPPV related complications were noted in the study group.


CONCLUSIONS
We concluded that NIPPV is an appropriate mode of ventilation in neonates requiring respiratory support. The major advantage of NIPPV is the non-invasive mechanics. It is also less expensive and less labor intensive. Further randomized controlled trials with larger sample size are warranted to confirm our findings.
Manzar
Shabih
S
Neonatal Intensive Care Unit, Department of Child Health, Royal Hospital, Muscat, Sultanate of Oman. shabihman@hotmail.com
Nair
Arun K
AK
Pai
Mangalore G
MG
Paul
Jose
J
Manikoth
Prakash
P
Georage
Mariam
M
Al-Khusaiby
Saleh M
SM
D001784:Blood Gas Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D007442:Intubation, Intratracheal; D008297:Male; D008397:Masks; D009850:Oman; D010865:Pilot Projects; D011659:Pulmonary Gas Exchange; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000628:therapy*; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome