Nasal Continuous Positive Airway Pressure, Nasal Intermittent Positive Pressure Ventilation
Conditions
Brief summary
In the past, several studies have compared the effects between nasal intermittent positive pressure ventilation(NIPPV) and nasal continuous positive airway pressure(NCPAP) on the incidence of intubation in preterm infants, and the results were inconsistent.The purpose of the present study was to compare NIPPV with NCPAP on the need for endotracheal ventilation and subsequent complications
Detailed description
To this day, early use of noninvasive respiratory support strategies has been suggested to be the most effective pathway to reduce those risks. Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) are two widely used ways of noninvasive ventilation strategies in preterm infant. As compared with invasive ventilation, NCPAP reduces the risks abnormal neurodevelopment. However, there is only 60% success rate of avoiding intubation in the preterm neonate supported with NCPAP. Supplying with an intermittent peak pressure on NCPAP, NIPPV is considered as a strengthened version of NCPAP with increased flow delivery in the upper airway, increased minute volume and functional residual capacity and recruitment of collapsed alveoli, improved stability of the chest wall and reduced asynchrony of thoraco-abdominal movement,which have been proven to be crucial to decrease the incidences of invasive ventilation and death. However, studies have compared the effects between nasal intermittent positive pressure ventilation(NIPPV) and nasal continuous positive airway pressure(NCPAP) on the incidence of intubation in preterm infants, and the results were inconsistent.
Interventions
DEVICENIPPV
NIPPV is used as a primary mode of ventilation in premature infants with respiratory distress syndrome
DEVICENCPAP
NCPAP is used as a primary mode of ventilation in premature infants with respiratory distress syndrome
Sponsors
Guiyang Maternity and Child Health Care Hospital
Children's Hospital of Chongqing Medical University
Chongqing Maternal and Child Health Hospital
Yan'an Affiliated Hospital of Kunming Medical University
The Children's Hospital of Zhejiang University School of Medicine
Chengdu Women's and Children's Central Hospital
Kunming Children's Hospital
Shanxi Provincial Maternity and Children's Hospital
Children's Hospital of Fudan University
Guangdong Women and Children Hospital
Nanjing Children's Hospital
Jiulongpo No.1 People's Hospital
Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
5 Minutes to 6 Hours
Healthy volunteers
No
Inclusion criteria
* Gestational age (GA) is from 26 to 37 weeks; * Diagnosis of RDS. The diagnosis of respiratory distress syndrome(RDS) will be based on clinical manifestations (tachypnea, nasal flaring and or grunting) and chest X-ray findings; * RDS Silverman score\>5; * Informed parental consent has been obtained.
Exclusion criteria
* Severe RDS requiring early intubation according to the American Academy of Pediatrics guidelines for neonatal resuscitation; * Major congenital malformations or complex congenital heart disease; * Group B hemolytic streptococcus pneumonia, septicemia, pneumothorax, pulmonary hemorrhage; * Cardiopulmonary arrest needing prolonged resuscitation; * Transferred out of the neonatal intensive care unit without treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| intubation rate | within 7 days | the infant is intubated ventilation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraventricular hemorrhage | within 28 days | the incidence of intraventricular hemorrhage |
| bronchopulmonary dysplasia | at a post-menstrual age of 36 weeks or at discharge | bronchopulmonary dysplasia was defined according to the National Institutes of Health consensus definition |
| Bayley Scales of Infant Development | at 2 months old and 2 years old | scores of Bayley Scales of Infant Development |
| Neonatal necrotizing enterocolitis(NEC) | within 7 days | the incidence of neonatal necrotizing enterocolitis(\>stage II);for NEC, Bell staging will be used |
Countries
China
Contacts
Primary ContactMa Juan, MD
Outcome results
None listed