Nasal Intermittent Positive Pressure Ventilation vs. Nasal Continuous Positive Airway Pressure in Preterm Infants with Respiratory Distress

The trend today is to minimize the use of mechanical ventilation. Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) are 2 non-invasive treatments for respiratory distress syndrome (RDS). There is little study in literature comparing early use of NIPPV with NCPAP as primary modes of respiratory support. The aim of this study is to determine whether NIPPV and NCPAP would have different survival rates and possible complications. In this prospective clinical trial study, 120 preterm neonates (gestational age 28-36 weeks) who were admitted due to respiratory distress between January and May 2012 in the neonatal intensive care unit of Afzalipour hospital. Sixty infants were randomized to NCPAP and comparable infants to NIPPV (birth weight 1807.05±52 vs. 1882.50±56 g, gestational age 32.05±2.94 vs. 32.16±2.08 weeks, respectively). Patients were randomly allocated into 2 treatment groups using minimization technique. One group was treated by NCPAP and the second one treated by NIPPV. Survival analysis was applied to estimate and compare survival rates. Infants treated initially with NIPPV needed less endotracheal ventilation than infants treated with NCPAP (13.3 % vs. 41.7 %, p=0.001). Estimated survival rates at 24 h in NIPPV were 97% versus 82% for NCPAP group. We have seen that the risk of failure for those received NCPAP was nearly 4 times higher than NIPPV group. According to our results, among preterm infants with suspected (RDS), the use of NIPPV reduces the need for intubation and mechanical ventilation in comparison to NCPAP.