Bi-PAP is not superior to NCPAP in the premature twins with respiratory distress syndrome: a prospective cohort study

Abstract

Background: Recently, non-invasive ventilation has been widely used due to the reduction of adverse effects of endotracheal intubation. Nevertheless nearly no researches have compared the efficacy of non-invasive respiratory support between preterm twins. The objective of this study was to determine if there is a decreased non-invasive ventilation (NIV) failure from bi-level positive airway pressure (Bi-PAP) vs nasal continuous positive airway pressure (NCPAP) in preterm twins as initial ventilation. Methods: This prospective cohort study enrolled 100 pairs preterm twins who were admitted to the NICU at Yunnan Qujing Maternity and Child Health Care Hospital from 2017.10 to 2020.09 for respiratory distress syndrome. One of the twin was randomly assigned to Bi-PAP, meanwhile another to NCPAP. The primary outcome was the incidence of NIV failure. Secondary outcomes was the occurrence rate of side-effects of NIV. Results: A total of 100 pairs preterm twins were included in statistical analysis. No distinct differences were found in NIV failure between groups (NCPAP vs Bi-PAP, 5% vs 2%, p = 0.248). We did not find any statistical difference in secondary outcome between Bi-PAP and NCPAP. Conclusions: In this prospective cohort study, among preterm twins with RDS, NCPAP was noninferior to Bi-PAP with respect to the reduction of the need for invasive mechanical ventilation (IMV).