Nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure for respiratory distress syndrome: a randomized, controlled, prospective study.
OBJECTIVE
To evaluate whether nasal intermittent mandatory ventilation (NIMV) compared with nasal continuous positive airway pressure (NCPAP) would decrease the requirement for endotracheal ventilation in the treatment of respiratory distress syndrome (RDS) in preterm infants <35 weeks.


METHODS
Randomized, controlled, prospective, single-center study. Forty-one infants were randomized to NCPAP and 43 comparable infants to NIMV (birth weight 1533 +/- 603 vs 1616 +/- 494 g, gestational age 30.6 +/- 3.0 vs 31.1 +/- 2.3 weeks, P = .5, respectively).


RESULTS
Infants treated with NIMV and with NCPAP had comparable cardio-respiratory status at study entry. In the total cohort, infants treated initially with NIMV needed less endotracheal ventilation than infants treated with NCPAP (25% vs 49%, P < .05) with a similar trend in infants <1500 g; 31% vs 62%, P =. 06). When controlling for weight and gestational age, NIMV was more successful in preventing endotracheal ventilation (P < .05). Infants treated with NIMV had a decreased incidence of bronchopulmonary dysplasia (BPD) compared with those treated with NCPAP (2% vs 17%, P <. 05, in the total cohort and 5% vs 33%, P <. 05, for infants <1500 g).


CONCLUSIONS
NIMV compared with NCPAP decreased the requirement for endotracheal ventilation in premature infants with RDS. This was associated with a decreased incidence of BPD.
Kugelman
Amir
A
Department of Neonatology, Bnai Zion Medical Center, The Bruce Rappaport Faculty of Medicine, Haifa, Israel. dramir@netvision.net.il
Feferkorn
Ido
I
Riskin
Arieh
A
Chistyakov
Irena
I
Kaufman
Bella
B
Bader
David
D
D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*