Sara B DeMauro1, David Millar, Haresh Kirpalani. 1. aThe Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA bDepartment of Neonatology, Royal Maternity Hospital, Belfast, UK.
Abstract
PURPOSE OF THE REVIEW: Noninvasive respiratory support for neonates is growing in popularity as clinicians increasingly recognize the dangers of prolonged invasive ventilation. The purpose of this review is to critically evaluate the existing evidence for safety and efficacy of these modes of respiratory support in neonates. RECENT FINDINGS: In recent years, multiple randomized controlled trials (RCTs) have evaluated several modes of noninvasive support, most importantly nasal intermittent positive pressure ventilation and high flow nasal cannulae, in comparison to the standard therapy of continuous positive airway pressure (CPAP). The three largest RCTs were recently published in 2013. One demonstrated no difference in death or survival with bronchopulmonary dysplasia between nasal intermittent positive pressure ventilation and CPAP, both when used as primary support and as postextubation support. Two others demonstrated that high flow nasal cannulae are noninferior to or no better than CPAP when used to support preterm infants after extubation. These trials showed no serious safety concerns with current modalities. SUMMARY: The optimal forms of noninvasive respiratory support for neonates remain to be determined. Continued evaluation of these technologies with large, well-designed RCTs is warranted.
PURPOSE OF THE REVIEW: Noninvasive respiratory support for neonates is growing in popularity as clinicians increasingly recognize the dangers of prolonged invasive ventilation. The purpose of this review is to critically evaluate the existing evidence for safety and efficacy of these modes of respiratory support in neonates. RECENT FINDINGS: In recent years, multiple randomized controlled trials (RCTs) have evaluated several modes of noninvasive support, most importantly nasal intermittent positive pressure ventilation and high flow nasal cannulae, in comparison to the standard therapy of continuous positive airway pressure (CPAP). The three largest RCTs were recently published in 2013. One demonstrated no difference in death or survival with bronchopulmonary dysplasia between nasal intermittent positive pressure ventilation and CPAP, both when used as primary support and as postextubation support. Two others demonstrated that high flow nasal cannulae are noninferior to or no better than CPAP when used to support preterm infants after extubation. These trials showed no serious safety concerns with current modalities. SUMMARY: The optimal forms of noninvasive respiratory support for neonates remain to be determined. Continued evaluation of these technologies with large, well-designed RCTs is warranted.
Authors: Ryan A Romans; Steven M Schwartz; John M Costello; Nikhil K Chanani; Parthak Prodhan; Avihu Z Gazit; Andrew H Smith; David S Cooper; Jeffrey Alten; Kshitij P Mistry; Wenying Zhang; Janet E Donohue; Michael Gaies Journal: Pediatr Crit Care Med Date: 2017-10 Impact factor: 3.624
Authors: Daniel L Hames; Lynn A Sleeper; Kevin J Bullock; Eric N Feins; Kimberly I Mills; Peter C Laussen; Joshua W Salvin Journal: Pediatr Crit Care Med Date: 2022-02-21 Impact factor: 3.971
Authors: Huayan Zhang; Kevin Dysart; Douglas E Kendrick; Lei Li; Abhik Das; Susan R Hintz; Betty R Vohr; Barbara J Stoll; Rosemary D Higgins; Leif Nelin; David P Carlton; Michele C Walsh; Haresh Kirpalani Journal: Pediatr Pulmonol Date: 2018-07-30
Authors: Lindsay Johnston; Taylor Sawyer; Anne Ades; Ahmed Moussa; Jeanne Zenge; Philipp Jung; Stephen DeMeo; Kristen Glass; Neetu Singh; Alexandra Howlett; Justine Shults; James Barry; Brianna Brei; Elizabeth Foglia; Akira Nishisaki Journal: Neonatology Date: 2021-06-10 Impact factor: 5.106
Authors: Danny Cantin; Djamal Djeddi; Vincent Carrière; Nathalie Samson; Stéphanie Nault; Wan Lu Jia; Jennifer Beck; Jean-Paul Praud Journal: PLoS One Date: 2016-01-19 Impact factor: 3.240
Authors: Amika A Kamath; Marielle J Kamath; Selin Ekici; Anna Sofia Stans; Christopher E Colby; Jane M Matsumoto; Mark E Wylam Journal: 3D Print Med Date: 2022-08-01
Authors: Laura E Ellington; Rosario Becerra Velásquez; José Tantaleán da Fieno; Gabriela Mallma Arrescurrenaga; Katie R Nielsen Journal: MedEdPORTAL Date: 2020-08-07