L S Owen1, C J Morley, P G Davis. 1. Royal Women's Hospital, Grattan Street, Carlton, VIC 3053, Australia. louise.owen@rwh.org.au
Abstract
BACKGROUND: Less invasive techniques of respiratory support are increasingly popular. OBJECTIVE: To determine how widespread the use of neonatal nasal intermittent positive airway pressure (NIPPV) has become and describe the range of practice used in NIPPV in England. METHODS: 95 English Neonatal intensive care units were asked to provide information about NIPPV devices, interfaces, indications, guidelines, use of synchronisation, complications, settings and weaning. RESULTS: 91 (96%) units replied. NIPPV was used by 44/91 (48%) units; few complications were seen. 34/44 (77%) used a synchronising device, 35/44 (80%) used NIPPV for "rescuing" babies for whom continuous positive airway pressure failed-59% routinely after extubation and 16% as a first-line treatment. A wide range of pressure and rate settings were used. CONCLUSIONS: In England, NIPPV is commonly used, with considerable variability in the techniques applied. The wide range of clinical approaches highlights the paucity of evidence available. More evidence is needed to establish best practice.
BACKGROUND: Less invasive techniques of respiratory support are increasingly popular. OBJECTIVE: To determine how widespread the use of neonatal nasal intermittent positive airway pressure (NIPPV) has become and describe the range of practice used in NIPPV in England. METHODS: 95 English Neonatal intensive care units were asked to provide information about NIPPV devices, interfaces, indications, guidelines, use of synchronisation, complications, settings and weaning. RESULTS: 91 (96%) units replied. NIPPV was used by 44/91 (48%) units; few complications were seen. 34/44 (77%) used a synchronising device, 35/44 (80%) used NIPPV for "rescuing" babies for whom continuous positive airway pressure failed-59% routinely after extubation and 16% as a first-line treatment. A wide range of pressure and rate settings were used. CONCLUSIONS: In England, NIPPV is commonly used, with considerable variability in the techniques applied. The wide range of clinical approaches highlights the paucity of evidence available. More evidence is needed to establish best practice.