Comparison of Nasal Synchronized Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in the Treatment of Neonatal Respiratory Distress Syndrome in Premature Infants

Abstract

Objective To investigate efficacy and safety of nasal synchronized intermittent positive pressure ventilation (NSIPPV) and nasal continuous positive airway pressure (NCPAP) after INSURE procedure in the treatment of neonatal respiratory distress syndrome (NRDS) in premature infants. Methods A total of 51 premature infants who were diagnosed as NRDS and required respiratory support hospitalization and treatment in neonatal department of Zhuzhou Maternal and Child Health Care Hospital of Hunan Province from January 2012 to July 2013 were chosen as study subjects. They were randomly assigned to NSIPPV group (n=25) and NCPAP group (n=26) in accordance with the respiratory support mode. The arterial oxygen pressure (), arterial carbon dioxide tension (), respiratory index (RI), complications and outcomes before respiratory support and 6 h, 24 h, 48 h after respiratory support between two groups were analyzed and compared. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Zhuzhou Maternal and Child Health Care Hospital. Informed consent was obtained from the parents of each participating patient. The general clinical data such as gender, gestational age and birth weight between two groups had no statistically significant difference(P>0.05). Results The results of this study followed as:①The , and RI levels prior treatment between two groups had no statistically significant difference (P >0.05).② Comparison of level : There were no statistically significant difference between two groups 6 h and 24 h post-treatment (P > 0.05),but the level of NSIPPV group was statistically higher than that of NCPAP group 48 h post-treatment(P 0.05).③Comparison of level:There were no statistically significant difference between two groups in three time points post-treatment(P>0.05) ; The level in the two groups both had no significant difference compared 6 h post-treatment to prior treatment and compared 24 h post-treatment to 48 h post-treatment in the same group (P > 0.05),but the level in the two groups both were statistically lower compared 24 h, 48 h post-treatment to prior treatment and compared 24 h, 48 h post-treatment to 6 h post-treatment in the same group(P 0.05), but nasal ventilation time of NSIPPV group was statistically less than NCPAP group (P < 0.05). Both groups had no bronchial pulmonary dysplasia (BPD), intracranial hemorrhage and gas leakage. Conclusions NSIPPV and NCPAP two kinds of noninvasive ventilation mode for treatment of NRDS had a good effect, which can significantly improve lung oxygenation function. Carbon dioxide retention was not obvious. Both modes had better safety. NSIPPV was more efficient than NCPAP for treatment of NRDS, nasal ventilation time was shorter and the capacity to improve pulmonary ventilation and oxygen exchange was greater. Key words: Intermittent positive-pressure ventilation; Continuous positive airway pressure; Respiratory distress syndrome, newborn; Infant, premature