title: A prospective, randomized, controlled study of NIPPV versus nCPAP in preterm and term infants with respiratory distress syndrome.
abstract: OBJECTIVE
  To evaluate whether nasal intermittent positive pressure ventilation (NIPPV) compared with nasal continuous positive airway pressure (nCPAP) decreases the requirement for endotracheal ventilation in preterm and term infants with respiratory distress syndrome (RDS).
  
  
  METHODS
  This was a single center, randomized, controlled trial. A total of 179 preterm and term infants with RDS were randomized to NIPPV (n = 88) or nCPAP (n = 91). The clinical data of enrolled infants including blood gas analysis, PaO2 /FiO2 ratio, incidence of intubation, and complications, if occurred, were recorded. The primary outcome was the need for endotracheal ventilation. The secondary outcome was the measurement of favorable outcome, which was defined as discharged without any respiratory support and feeding well and gaining weight. Analysis followed slightly modified intention to treat principle.
  
  
  RESULTS
  Significantly less number of infants randomized to NIPPV group required intubation and mechanical ventilation compared with nCPAP group (11.4% vs. 20.9%, P < 0.05). A favorable outcome was more likely in infants randomized to NIPPV (93.2% vs. 84.6%, P < 0.05). In subgroup analysis, NIPPV was associated with reduced need for intubation in preterm (9.9% vs. 19.2%) and term (17.6% vs. 27.8%) infants, but the difference was statistically significant only in preterm infants(P < 0.05).
  
  
  CONCLUSIONS
  Treatment with NIPPV compared with nCPAP decreased the need for endotracheal ventilation and increased favorable outcome in preterm and term infants with RDS.
authors.affiliation: Department of Pediatrics, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shi
authors.forename: Shifang
authors.initials: S
authors.lastname: Tang
authors.forename: Jinning
authors.initials: J
authors.lastname: Zhao
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
mesh_terms: D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D057194:Intention to Treat Analysis; D007385:Intermittent Positive-Pressure Ventilation; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D016896:Treatment Outcome
keywords: infant; mechanical ventilation; nasal continuous positive airway pressure; nasal intermittent positive pressure ventilation; neonatal respiratory distress syndrome; newborn