Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants
WANG Zhu, XIANG Jian-Wen, GAO Wei-Wei, SHEN Yong-Zhen, ZHOU Wen-Ji, CHEN Jia, XU Fang, YANG Jie
Department of Neonatology, Guangdong Women and Children's Hospital, Guangzhou 511400, China
Abstract:Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among very low birth weight (VLBW) preterm infants.Methods A total of 89 very low birth weight premature infants with respiratory distress syndrome (RDS) who were randomly administered with NIPPV (n=46) and HHHFNC (n=43) as an initial respiratory support. The incidence of initial treatment failure, the usage of pulmonary surfactant (PS), the parameters of respiratory support treatment and the incidence of complications were compared between the two groups.Results There were no significant differences between the NIPPV and HHHFNC groups in the following items:the rate of intubation within 72 hours, rate of PS use, duration of invasive or non-invasive mechanical ventilation, duration of oxygen therapy, and incidence rates of severe apnea and pneumonia (P > 0.05). There were also no significant differences in the incidence rates of bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, intracranial hemorrhage, and air leak between the two group (P > 0.05). The incidence rate of nose injury in the NIPPV group was higher than that in the HHHFNC group (P < 0.05).Conclusions As an initial respiratory support for very low birth weight preterm infants with RDS, HHHFNC has a similar clinical effect as NIPPV, suggesting that HHHFNC is a safe and effective clinical option as a non-invasive ventilation treatment.
WANG Zhu,XIANG Jian-Wen,GAO Wei-Wei et al. Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants[J]. CJCP, 2018, 20(8): 603-607.
Lemyre B, Davis PG, De Paoli AG, et al. Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation[J]. Cochrane Database Syst Rev, 2014, 3(9):CD003212.
[6]
Wilkinson D, Andersen C, O'Donnell CPF, et al. High flow nasal cannula for respiratory support in preterm infants[J].Cochrane Database Syst Rev, 2016, 66(5):CD006405.
Kugelman A, Riskin A, Said W, et al. A randomized pilot study comparing heated humidified high-flow nasal cannulae with NIPPV for RDS[J]. Pediatr Pulmonol, 2015, 50(6):576-583.
Ramanathan R, Sekar KC, Rasmussen M, et al. Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress syndrome in preterm infants<30 weeks' gestation:a randomized, controlled trial[J]. J Perinatol, 2012, 32(5):336-343.
[14]
Kahramaner Z, Erdemir A, Turkoglu E. Unsynchronized nasal intermittent positive pressure versus nasal continuous positive airway pressure in preterm infants after extubation[J]. J Matern Fetal Neonatal Med, 2014, 27(9):926-929.
[15]
Sai Sunil Kishore M, Dutta S, Kumar P. Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome[J]. Acta Paediatrica, 2009, 98(9):1412-1415.
[16]
Meneses J, Bhandari V, Alves JG. Nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome:a systematic review and meta-analysis[J]. Arch Pediatr Adolesc Med, 2012, 166(4):372-376.
Saslow JG, Aghai ZH, Nakhla TA, et al. Work of breathing using high-flow nasal cannula in preterm infants[J]. J Perinatol, 2006, 26(8):476-480.
[19]
Jeon GW. Respiratory support with heated humidified high flow nasal cannula in preterm infants[J]. Korean J Pediatr, 2016, 59(10):389-394.
[20]
Calum T, Roberts MB, Ch B, et al. Nasal high-flow therapy for primary respiratory support in preterm infants[J]. N Engl J Med, 2016, 375(12):1142-1151.
[21]
Kong X, Xu F, Wu R, et al. Neonatal mortality and morbidity among infants between 24 to 31 complete weeks:a multicenter survey in China from 2013 to 2014[J]. BMC Pediatr, 2016, 16(1):174.