title: Heliox non-invasive ventilation for preventing extubation failure in preterm infants.
abstract: OBJECTIVE
  Our aim was to assess whether non-invasive ventilation with heliox may decrease the incidence of extubation failure in preterm infants with RDS.
  
  
  METHODS
  Infants <29 weeks of gestation were treated immediately after extubation with heliox combined with nasal continuous airway pressure (Hx-NCPAP) or bilevel NCPAP (Hx-BiPAP) for 24 h, while infants in the control groups were treated with conventional NCPAP or BiPAP. The primary endpoint was the comparison of the extubation failure rate in the two groups, where failure was defined as the need for MV during the 24 h following extubation.
  
  
  RESULTS
  Eighteen infants were assigned to the heliox group and 18 to the control group. The extubation failure rate was similar (p = 0.249) in the heliox (n = 6; 33%) and in the control group (n = 9; 50%), but required mean airway pressure (MAP: 4.0+1.0 vs. 4.8+1.2 cm H2O; p = 0.037) and PaCO2 (39+8 mmHg vs. 52+7 mmHg; p < 0.001) at 24 h of treatment were lower in the heliox group.
  
  
  CONCLUSIONS
  Non-invasive ventilation with heliox was not effective in decreasing extubation failure in preterm infants with RDS, but did improve their respiratory function. Our findings might support the planning of large randomized controlled studies to evaluate the effectiveness of heliox non-invasive ventilation for decreasing extubation failure in premature infants.
authors.affiliation: Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Italy. cdani@unifi.It
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: Giulia
authors.initials: G
authors.lastname: Fontanelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lori
authors.forename: Federica
authors.initials: F
authors.lastname: Favelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Poggi
mesh_terms: D060666:Airway Extubation / Q000706:statistics & numerical data*; D005260:Female; D006371:Helium / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D063087:Noninvasive Ventilation; D010100:Oxygen / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D017211:Treatment Failure
chemical_list: D006371:Helium; C038949:heliox; D010100:Oxygen