Comparison of Complications and Efficacy of NIPPV and Nasal CPAP in Preterm Infants With RDS.
BACKGROUND
Respiratory distress syndrome (RDS) is one of the most common diseases in neonates admitted to NICU. For this important cause of morbidity and mortality in preterm neonates, several treatment methods have been used. To date, non-invasive methods are preferred due to fewer complications.


OBJECTIVE
Herein, two non-invasive methods of ventilation support are compared: NCPAP vs. NIPPV.


METHODS
This is a randomized clinical trial. Premature neonates with less than 34 weeks gestation, suffering from RDS entered the study, including 151 newborns admitted to Vali-Asr NICU during 2012-2013. Most of these patients received surfactant as early rescue via INSURE method and then randomly divided into two NCPAP (73 neonates) and NIPPV (78 neonates) groups. Both early and late complications are compared including extubation failure, hospital length of stay, GI perforation, apnea, intraventricular hemorrhage (IVH) and mortality rate.


RESULTS
The need for re-intubation was 6% in NIPPV vs. 17.6% in NCPAP group, which was statistically significant (P = 0.031). The length of hospital stay was 23.92 ± 13.5 vs. 32.61 ± 21.07 days in NIPPV and NCPAP groups, respectively (P = 0.002). Chronic lung disease (CLD) was reported to be 4% in NCPAP and 0% in NIPPV groups (P = 0.035). The most common complication occurred in both groups was traumatization of nasal skin and mucosa, all of which fully recovered. Gastrointestinal perforation was not reported in either group.


CONCLUSIONS
This study reveals the hospital length of stay, re-intubation and BPD rates are significantly declined in neonates receiving NIPPV as the treatment for RDS.
Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Tahereh
T
Esmaeilnia
Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Fatemeh
F
Nayeri
Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Roya
R
Taheritafti
Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Mamak
M
Shariat
Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Faezeh
F
Moghimpour-Bijani
NCPAP; NIPPV; Prematurity; Respiratory Distress Syndrome