title: Nasal Intermittent Positive Pressure Ventilation for Preterm Neonates: Synchronized or Not?
abstract: Although continuous positive airway pressure (CPAP) is an effective strategy to prevent invasive ventilation, failure rates are high and many babies require endotracheal intubation. Prolonged exposure to mechanical ventilation is linked with bronchopulmonary dysplasia and other morbidities. Different techniques of nasal intermittent positive pressure ventilation (NIPPV) have been proposed as an alternative to CPAP. Bilevel NIPPV and conventional mechanical ventilator-driven NIPPV are used in clinical practice. Both methods differ substantially in pressures and cycling times, potentially affecting their mechanism of action. This review focuses on noninvasive ventilation strategies, their physiologic effects, impact on clinical outcome parameters, and effects of synchronization.
authors.affiliation: Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada. Electronic address: markus.waitz@paediat.med.uni-giessen.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Waitz
authors.affiliation: Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada.
authors.forename: Lars
authors.initials: L
authors.lastname: Mense
authors.affiliation: Division of Neonatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors.forename: Haresh
authors.initials: H
authors.lastname: Kirpalani
authors.affiliation: Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lemyre
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D045422:Continuous Positive Airway Pressure / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D063087:Noninvasive Ventilation / Q000379:methods*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*
keywords: BPD; Bilevel; NIPPV; Noninvasive ventilation; Preterm infant; Synchronization