Abstract
Objectives: To compare the effectiveness of continuous positive airway pressure (CPAP) and non-invasive positive pressure ventilation (NIPPV) in neonates with mild to moderate respiratory distress. Method: A single centre randomized controlled trial was conducted at the Sri Jayawardenepura General Hospital, Sri Lanka from January to December 2015. The trial was registered with The Clinical Trials Registry ‘Clinical Trials.gov’ retrospectively. Eighty neonates admitted to the neonatal intensive care unit (NICU) were randomly allocated to NIPPV and CPAP. Outcomes of respiratory support were observed and information on risk factors were obtained by going through the bed head tickets of the study cohort. Data analysis was done using SPSS 20 software. Results: Infants treated with NIPPV and CPAP had comparable demographic data and clinical status at the time of enrolment into the study. Infants treated initially with NIPPV needed less endotracheal ventilation than infants treated with CPAP (35% vs 40%, p = 0.644) but this difference is not statistically significant. Conclusions: The risks for respiratory failure and the need for ventilation were not statistically significantly different whether using NIPPV or CPAP. Sri Lanka Journal of Child Health, 2018; 4 7 : 242-248
Highlights
Respiratory distress accounts for 30-40% of admissions to neonatal intensive care units (NICUs) and special care baby units (SCBUs)[1]
Infants treated with non-invasive positive pressure ventilation (NIPPV) and continuous positive airway pressure (CPAP) had comparable demographic data and clinical status at the time of enrolment into the study
Infants treated initially with NIPPV needed less endotracheal ventilation than infants treated with CPAP (35% vs 40%, p = 0.644) but this difference is not statistically significant
Summary
Respiratory distress accounts for 30-40% of admissions to neonatal intensive care units (NICUs) and special care baby units (SCBUs)[1]. Whilst non-invasive respiratory support causes minimal damage to the developing neonatal lung parenchyma and minimal systemic damage, invasive ventilation can lead to permanent lung damage with poor respiratory capacity, frequent wheezing and broncho-pulmonary dysplasia. National Emergency Obstetric and Neonatal Care Needs Assessment Country Report published in 2012 by the Ministry of Health and the Family Health Bureau of Sri Lanka shows total ventilation as a percentage of total admissions to neonatal care units to be 5.4% and nasal CPAP support as 3.9%. There is no data regarding NIPPV use. Most centres in Sri Lanka use CPAP as a non-invasive method and conventional ventilation as an invasive method
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