Sorabh Goel1, Jayashree Mondkar, Harshad Panchal, Deeparaj Hegde, Alpana Utture, Swati Manerkar. 1. Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal and General Hospital, Mumbai, India. Correspondence to: Dr Sorabh Goel, Department of Neonatology, LTMMC and LTMG hospital, Sion (West), Mumbai 400 022, India. drsorabhgoel1982@gmail.com.
Abstract
OBJECTIVE: To compare the effectiveness of nasal continuous positive airway pressure delivered by Nasal mask vs Nasal prongs with respect to continuous positive airway pressure failure. STUDY DESIGN: Randomized, controlled, open label, trial. SETTING:Tertiary care level III neonatal unit. PARTICIPANTS: 118 preterm infants-gestational age (27-34 weeks) requiring nasal continuous positive airway pressure as a primary mode for respiratory distress, who were treated with either nasal mask (n=61) or nasal prongs (n=57) as interface. PRIMARY OUTCOME: Need for mechanical ventilation within 72 h of initiating support. RESULTS:Nasal continuous positive airway pressure failure occurred in 8 (13%) of Mask group and 14 (25%) of Prongs group but was statistically not significant (RR 0.53, 95% CI 0.24-1.17) (P = 0.15). The rate of pulmonary interstitial emphysema was significantly less in the Mask group (4.9% vs. 17.5%; RR 0.28, 95% CI 0.08-0.96; P = 0.03). Incidence of moderate nasal trauma (6.5% vs 21%) (P=0.03) and overall nasal trauma (36% vs 58%) (P=0.02) were significantly lower in mask group than in the prongs group. CONCLUSIONS: Nasal continuous positive airway pressure with mask as interface is as effective as prongs but causes less nasal trauma and pulmonary interstitial emphysema.
RCT Entities:
OBJECTIVE: To compare the effectiveness of nasal continuous positive airway pressure delivered by Nasal mask vs Nasal prongs with respect to continuous positive airway pressure failure. STUDY DESIGN: Randomized, controlled, open label, trial. SETTING: Tertiary care level III neonatal unit. PARTICIPANTS: 118 preterm infants-gestational age (27-34 weeks) requiring nasal continuous positive airway pressure as a primary mode for respiratory distress, who were treated with either nasal mask (n=61) or nasal prongs (n=57) as interface. PRIMARY OUTCOME: Need for mechanical ventilation within 72 h of initiating support. RESULTS: Nasal continuous positive airway pressure failure occurred in 8 (13%) of Mask group and 14 (25%) of Prongs group but was statistically not significant (RR 0.53, 95% CI 0.24-1.17) (P = 0.15). The rate of pulmonary interstitial emphysema was significantly less in the Mask group (4.9% vs. 17.5%; RR 0.28, 95% CI 0.08-0.96; P = 0.03). Incidence of moderate nasal trauma (6.5% vs 21%) (P=0.03) and overall nasal trauma (36% vs 58%) (P=0.02) were significantly lower in mask group than in the prongs group. CONCLUSIONS: Nasal continuous positive airway pressure with mask as interface is as effective as prongs but causes less nasal trauma and pulmonary interstitial emphysema.
Authors: Giorgio Conti; Giorgia Spinazzola; Cesare Gregoretti; Giuliano Ferrone; Andrea Cortegiani; Olimpia Festa; Marco Piastra; Luca Tortorolo; Roberta Costa Journal: BMC Pulm Med Date: 2018-04-07 Impact factor: 3.317
Authors: Paulo André Freire Magalhães; Ana Carolina Gusmão D'Amorim; Elis Fernanda Araújo Lima de Oliveira; Maria Evelyne Albuquerque Ramos; Ana Patrícia Duarte de Aquino Mendes; Juliana Fernandes de Souza Barbosa; Cyda Maria Albuquerque Reinaux Journal: Rev Bras Ter Intensiva Date: 2022 Apr-Jun