Hussain Alsaid Ahmad1, Veena Deekonda2, Waseemoddin Patel3, Lehana Thabane1, Prakesh S Shah4, Amit Mukerji1. 1. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. 2. Department of Respiratory Therapy, Hamilton Health Sciences, Hamilton, Ontario, Canada. 3. Division of Neonatology, Department of Pediatrics, Princess Nourah Bint AbdulRahman University, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. 4. Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: The aim of this study was to compare outcomes following receipt of high continuous positive airway pressure (CPAP) versus nasal intermittent positive pressure ventilation (NIPPV) in extremely preterm neonates. STUDY DESIGN: We retrospectively compared outcomes of preterm neonates (22-28 weeks' gestation) following their first episode of either high CPAP (≥ 9 cmH2O) or NIPPV. Primary outcome was failure of high CPAP or NIPPV within 7 days, as determined by either need for intubation or use of an alternate noninvasive mode. RESULTS: During the 3-year study period, 53 infants received high CPAP, while 119 patients received NIPPV. There were no differences in the primary outcome (adjusted odds ratio 1.21; 95% confidence interval 0.49-3.01). The use of alternate mode of noninvasive support was higher with the use of high CPAP but no other outcome differences were noted. CONCLUSION: Based on this cohort, there was no difference in incidence of failure between high CPAP and NIPPV, although infants receiving high CPAP were more likely to require an alternate mode of noninvasive support. KEY POINTS: · Use of high CPAP pressures (defined as ≥9 cmH2O) is gradually increasing during care of preterm neonates.. · Limited data exists regarding its efficacy and safety.. · This study compares high CPAP with NIPPV, and demonstrates comparable short-term clinical outcomes.. Thieme. All rights reserved.
OBJECTIVE: The aim of this study was to compare outcomes following receipt of high continuous positive airway pressure (CPAP) versus nasal intermittent positive pressure ventilation (NIPPV) in extremely preterm neonates. STUDY DESIGN: We retrospectively compared outcomes of preterm neonates (22-28 weeks' gestation) following their first episode of either high CPAP (≥ 9 cmH2O) or NIPPV. Primary outcome was failure of high CPAP or NIPPV within 7 days, as determined by either need for intubation or use of an alternate noninvasive mode. RESULTS: During the 3-year study period, 53 infants received high CPAP, while 119 patients received NIPPV. There were no differences in the primary outcome (adjusted odds ratio 1.21; 95% confidence interval 0.49-3.01). The use of alternate mode of noninvasive support was higher with the use of high CPAP but no other outcome differences were noted. CONCLUSION: Based on this cohort, there was no difference in incidence of failure between high CPAP and NIPPV, although infants receiving high CPAP were more likely to require an alternate mode of noninvasive support. KEY POINTS: · Use of high CPAP pressures (defined as ≥9 cmH2O) is gradually increasing during care of preterm neonates.. · Limited data exists regarding its efficacy and safety.. · This study compares high CPAP with NIPPV, and demonstrates comparable short-term clinical outcomes.. Thieme. All rights reserved.
Authors: Mar Janna Dahl; Chiara Veneroni; Anna Lavizzari; Sydney Bowen; Haleigh Emerson; Andrew Rebentisch; Elaine Dawson; Kyle Summers; Luke Pettet; Zhengming Wang; Donald M Null; Bradley A Yoder; Raffaele L Dellacà; Kurt H Albertine Journal: Am J Physiol Lung Cell Mol Physiol Date: 2021-05-19 Impact factor: 6.011