Clinical Study of Different Modes of Non-invasive Ventilation Treatment in Preterm Infants With Respiratory Distress Syndrome After Extubation.

Fei Ding,Qian Zhao,Zimei Cheng,Hui Wu,Tao Bo,Yang Wang,Jingling Zhang,Wenya Zhang

doi:10.3389/fped.2020.00063

Abstract

Objective: This study aimed to investigate the clinical efficacy and safety of different non-invasive respiratory support methods in preterm infants with respiratory distress syndrome (RDS) after extubation.Methods: From Oct 2017 to 2018, 120 preterm infants were recruited from the NICUs of three hospitals. They were diagnosed with RDS and required mechanical ventilation. After extubation from mechanical ventilation, these infants were divided into NCPAP group, SNIPPV group and SNIPPV + NCPAP group. The time of non-invasive ventilation, reintubation rate within 72 h, success rate of non-invasive ventilation within 1 week, duration of oxygen therapy, hospital stay and incidence of complications were recorded and compared.Results: Compared with the NCPAP group, the SNIPPV group and the SNIPPV + NCPAP group had significantly higher rate of successful extubation and removal from non-invasive ventilation within 1 week (P < 0.05). There were no significant differences among three groups in the time of non-invasive ventilation, time of oxygen therapy, hospital stay or incidence of complications (P > 0.05).Conclusion: SNIPPV + NCPAP after mechanical ventilation is a relatively safe and effective ventilation strategy for preterm infants with severe RDS. The use of NCPAP facilitates the turnover of SNIPPV ventilators in developing countries.

Highlights

With the development of perinatal medicine, the survival rate of preterm infants with extremely/ultra-low birth weight has increased yearly, and the incidence of respiratory distress syndrome (RDS) has increased over year
It is possible to reduce the time of synchronized nasal intermittent positive pressure ventilation (SNIPPV) in RDS infants and ease the burden without increasing the failure rate of extubation if the infants are initially administered with respiratory support by SNIPPV after the weaning of mechanical ventilation and with Nasal continuous positive airway pressure ventilation (NCPAP)
The present study aimed to explore the efficacy and safety of sequential application of SNIPPV and NCPAP in extubated preterm infants with RDS

Summary

Introduction

With the development of perinatal medicine, the survival rate of preterm infants with extremely/ultra-low birth weight has increased yearly, and the incidence of respiratory distress syndrome (RDS) has increased over year. Mechanical ventilation can quickly and effectively improve the clinical symptoms of preterm infants with severe RDS, but long-term invasive ventilation may increase the risks for ventilator-associated lung injury and infection. The mechanical ventilation in preterm infants with severe RDS should be switched to. In recent years, synchronized nasal intermittent positive pressure ventilation (SNIPPV) has been increasingly used in China as an enhanced mode of NCPAP. It is possible to reduce the time of SNIPPV in RDS infants and ease the burden without increasing the failure rate of extubation if the infants are initially administered with respiratory support by SNIPPV after the weaning of mechanical ventilation and with NCPAP.

Methods

Results

Conclusion