Effect of nasal prongs or nasal mask for non-invasive positive pressure ventilation in preterm infants with respiratory distress syndrome

Abstract

Objective To understand the characteristics of nasal prongs or nasal mask for non-invasive positive pressure ventilation in preterm infants with respiratory distress syndrome (RDS). Methods Ninety-three RDS preterm infants from August 2012 to June 2013 were chosen and divided into the nasal prong group (n=48) or nasal mask group (n=45) according to the random number table. The nasal prong group received the short binasal prongs as the connection interface, and the nasal mask group received the nasal mask. The parameters including fraction of inspiration O2 (FiO2) were adjusted according to transcutaneous oxygen saturation monitoring or blood gas analysis, and the various parameters and incidence rate of adverse reaction were recorded. Results After 12-24 h of non-invasive positive pressure ventilation, the level of pH, PaCO2, FiO2, abdominal distension, the average time of non-invasive ventilation and the failure cases of non-invasive ventilation were respectively (7.32±0.06), (48.2±9.0) mmHg, (0.39±0.08), 3 cases, (54.1±16.8) h and 12 cases in the nasal prong group, and were (7.31±0.07), (47.2±10.2) mmHg, (0.38±0.08), 5 cases, (54.8±13.6) h and 9 cases in the nasal mask group, and the differences were not statistically significant (t/χ2=0.169, 0.484, 0.464, 0.217, -0.226, 0.332, respectively; P>0.05). The total numbers of falling off and leaking gas were respectively 89 and 352 in the nasal prong group, and were lower than 48 and 489 in the nasal mask group, and the differences were statistically significant (χ2=8.898, 44.644, respectively; P 0.05). But the sites of nasal injury between two groups were significant different, and the sites of nasal injury in the nasal prong group were almost around the medial aspect of the nasal septum and the columella, and were around the junction of the nasal septum and philtrum and the glabella in the nasal mask group. Conclusions The nasal prongs fall off more easily than nasal masks, and the nasal mask leaks more easily than nasal prongs, but there are no significant differences in the duration and the failure rate of noninvasive ventilation between the two types of connection interfaces. The incidence rate and degree of nasal injury causes by the nasal prongs or nasal mask are similar, but the sites of nasal injury are different. Key words: Neonatal respiratory distress syndrome; Nasal prongs; Nasal mask; Non-invasive ventilation; Preterm infants