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Nasal continuous positive airway pressure versus nasal intermittent positive-pressure ventilation within the minimally invasive surfactant therapy approach in preterm infants: a randomised controlled trial.

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Nasal continuous positive airway pressure versus nasal intermittent positive-pressure ventilation within the minimally invasive surfactant therapy approach in preterm infants: a randomised controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Oncel, Mehmet Yekta Arayici, Sema Uras, Nurdan Alyamac-Dizdar, Evrim Sari, Fatma Nur Karahan, Sevilay Canpolat, Fuat Emre Oguz, Serife Suna Dilmen, Ugur
Description	Country affiliation: Turkey Author Affiliation: Oncel MY ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Arayici S ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Uras N ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Alyamac-Dizdar E ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Sari FN ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Karahan S ( Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.); Canpolat FE ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Oguz SS ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.); Dilmen U ( Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey Department of Pediatrics, School of Medicine, Yildirim Beyazit University, Ankara, Turkey.)
Abstract	OBJECTIVE: To compare the effectiveness of nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive-pressure ventilation (NIPPV) as the initial respiratory support within the minimally invasive surfactant therapy (MIST) approach in preterm infants with respiratory distress syndrome. DESIGN: Prospective, randomised controlled study. SETTING: Tertiary neonatal intensive care unit. PATIENTS AND INTERVENTIONS: This study enrolled 200 preterm infants with a gestational age of 26-32â weeks who showed signs of respiratory distress but did not require intubation in the delivery room. Surfactant therapy was performed using the MIST approach in the patients who met the criteria for surfactant administration. MAIN OUTCOME MEASURES: The primary outcomes were a need for intubation within the first 72â h of life and a surfactant requirement. RESULTS: The infants in the study displayed similar characteristics at birth. Fewer infants in the NIPPV group required surfactant therapy (38% vs 60%; p=0.002) or invasive ventilation during the first 72â h of life (13% vs 29%; p=0.005), and NIPPV reduced the rate of moderate-to-severe bronchopulmonary dysplasia (BPD) (7% vs 16%; p=0.046). Multivariate logistic regression analysis showed that NIPPV support (OR: 0.36, 95% CI 0.17 to 0.76; p=0.008) and higher gestational age (OR: 0.76, 95% CI 0.59 to 0.98; p=0.041) reduced the need for invasive ventilation within the first 72â h of life. Surfactant requirement was also decreased with NIPPV support (OR: 0.39, 95% CI 0.22 to 0.71; p=0.002). However, there was no impact on BPD, based on the multivariate analysis. CONCLUSIONS: In infants born at 26-32â weeks' gestation, NIPPV reduced the need for invasive ventilation and the surfactant requirement within the MIST approach. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov under identifier NCT01741129.
File Format	HTM / HTML
ISSN	13592998
Issue Number	4
Journal	Archives of Disease in Childhood - Fetal and Neonatal Edition
Volume Number	101
e-ISSN	14682052
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2016-07-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pediatrics Discipline Perinatology
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health Obstetrics and Gynecology

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