Noninvasive Ventilation in Newborns <= 1,500 g after Tracheal Extubation: Randomized Clinical Trial

Noninvasive Ventilation in Newborns <= 1,500 g after Tracheal Extubation: Randomized Clinical Trial

Author Santos Ribeiro, Simone Nascimento Google Scholar
Fernandes Fontes, Maria Jussara Google Scholar
Bhandari, Vineet Google Scholar
Resende, Camilla Borges Google Scholar
Johnston, Cintia Autor UNIFESP Google Scholar
Abstract Objective Our aim was to compare the success of extubation in neonates managed with nonsynchronized intermittent nasal positive-pressure ventilation (nsNIPPV) and two modes of nasal continuous positive airway pressure (NCPAP) after the first extubation. Study Design Randomized controlled clinical trial conducted in the neonatal intensive care unit (NICU) included infants with gestational age <= 34 weeks and birth weights (BW) 500 to 1,500 g with a diagnosis of respiratory distress syndrome (RDS), divided into three groups: ventilation with nsNIPPV, bubble-NCPAP, and ventilator-NCPAP. Extubation failure (EF) was defined as occurring within 48 hours after extubation. Results We included 101 newborns: nsNIPPV (n = 36)

bubble-NCPAP (n = 32) ventilator-NCPAP (n = 33). Overall, the extubation success rate was 81.2%. There were no skin, gastric, or pulmonary complications related to noninvasive ventilation (NIV) (p = 1). There was no difference between the groups regarding the success/EF (p = 0.4). There was extubation success in 81 (81.2%) cases, and EF occurred in 20 (19.8%), associated with longer invasive mechanical ventilation time (p < 0.001) and development of bronchopulmonary dysplasia (p = 0.04). Conclusion In this trial, three modalities of NIV applied in the success/failure outcomes of extubation avoided reintubation in 80% of infants.
Keywords newborn
noninvasive ventilation
respiratory distress syndrome
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2017
Published in American Journal Of Perinatology. New York, v. 34, n. 12, p. 1190-1198, 2017.
ISSN 0735-1631 (Sherpa/Romeo, impact factor)
Publisher Thieme Medical Publ Inc
Extent 1190-1198
Access rights Closed access
Type Article
Web of Science ID WOS:000411865900004

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