Non-synchronized nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) after extubation in preterm infants with respiratory distress syndrome

Abstract

Objective: To determine whether non-synchronized nasal intermittent positive pressure ventilation (NIPPV) reduces the rates of extubation failure, compared to nasal continuous positive airway pressure (NCPAP), in preterm infants with respiratory distress syndrome (RDS). Method: This retrospective study included a total of 49 premature infants who were born at <32 gestational weeks with a birth weight of <1.500 g and required intubation due to RDS. The patients were followed up with NIPPV or NCPAP after extubation. The primary outcome was extubotion failure within 48 hrs of extubotion, while the secondary outcome was neonatal morbidities. Results: A total of 23 patients received NCPAP and 26 patients NIPPV following extubation. Demographic characteristics were similar in both NCPAP and NIPPV groups. Extubation failure was observed in five (21.7%) NCPAP, and in nine (34.6%) NIPPV patients, although any statistically significant intergroup difference was not detected (p=0.32). There were no significant intergroup differences as for post-extubation atelectasis, pneumothorax. Neonatal morbidities and mortality rates. However, the incidence of patent ductus arteriosus was statistically significantly higher in the NIPPV group (p<0.05). In none of the patients gastric or intestinal perforations were observed. Conclusion: It was concluded that NIPPV is not superior to NCPAP performed in preterm infants after extubation in reducing the incidence of reintubation and respiratory morbidities, including pneumothorax and post-extubation atelectasis.