title: Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation.
abstract: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV) after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV) and continuous positive airway pressure (nCPAP).
  Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA) ≤ 36 weeks and birth weight (BW) > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation.
  Among the 36 premature infants randomized to nIPPV, six (16.6%) presented extubation failure in comparison to 11 (30.5%) of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study.
  We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.
authors.affiliation: MSc in Pediatrics from Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Daniela Franco Rizzo
authors.initials: DF
authors.lastname: Komatsu
authors.affiliation: Associate Professor, Habilitation (BR: Livre-docência) in Neonatology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Edna Maria de Albuquerque
authors.initials: EM
authors.lastname: Diniz
authors.affiliation: PhD Professor, Division of Preventive and Social Pediatrics, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Alexandre Archanjo
authors.initials: AA
authors.lastname: Ferraro
authors.affiliation: Professor, Habilitation (BR: Livre-docência) in Neonatology, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Maria Esther Jurvest Rivero
authors.initials: ME
authors.lastname: Ceccon
authors.affiliation: Full Professor, Department of Pediatrics, FMUSP, São Paulo, SP, Brazil.
authors.forename: Flávio Adolfo Costa
authors.initials: FA
authors.lastname: Vaz
mesh_terms: D001034:Apgar Score; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D015300:Ventilator Weaning