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AJP Rep 2016; 06(03): e264-e271
DOI: 10.1055/s-0036-1586205
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effectiveness of Synchronized Noninvasive Ventilation to Prevent Intubation in Preterm Infants

Cristina Ramos-Navarro
1   Neonatology Division, Department of Pediatrics, Gregorio Marañon Biomedical Research Institute, Gregorio Marañon University Hospital, Complutense University, Madrid, Spain
,
Manuel Sanchez-Luna
1   Neonatology Division, Department of Pediatrics, Gregorio Marañon Biomedical Research Institute, Gregorio Marañon University Hospital, Complutense University, Madrid, Spain
,
Ester Sanz-López
1   Neonatology Division, Department of Pediatrics, Gregorio Marañon Biomedical Research Institute, Gregorio Marañon University Hospital, Complutense University, Madrid, Spain
,
Elena Maderuelo-Rodriguez
1   Neonatology Division, Department of Pediatrics, Gregorio Marañon Biomedical Research Institute, Gregorio Marañon University Hospital, Complutense University, Madrid, Spain
,
Elena Zamora-Flores
1   Neonatology Division, Department of Pediatrics, Gregorio Marañon Biomedical Research Institute, Gregorio Marañon University Hospital, Complutense University, Madrid, Spain
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Publikationsverlauf

05. März 2016

14. Juni 2016

Publikationsdatum:
04. August 2016 (online)

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Abstract

Background Noninvasive ventilation is being increasingly used on preterm infants to reduce ventilator lung injury and bronchopulmonary dysplasia. The aim of this study was to evaluate the effectiveness of synchronized nasal intermittent positive pressure ventilation (SNIPPV) to prevent intubation in premature infants.

Methods Prospective observational study of SNIPPV use on preterm infants of less than 32 weeks' gestation. All patients were managed using a prospective protocol intended to reduce invasive mechanical ventilation (iMV) use. Previous respiratory status, as well as respiratory outcomes and possible secondary side effects were analyzed.

Results SNIPPV was used on 78 patients: electively to support extubation on 25 ventilator-dependent patients and as a rescue therapy after nasal continuous positive airway pressure failure on 53 patients. For 92% of patients in the elective group and 66% in the rescue group, iMV was avoided over the following 72 hours. No adverse effects were detected, and all patients were in a stable condition even if intubation was eventually needed.

Conclusions The application of SNIPPV in place of or to remove mechanical ventilation avoids intubation in 74.4% of preterm infants with respiratory failure. No adverse effects were detected.

Keywords

synchronized noninvasive ventilation - preterm infants - nCPAP failure - extubation failure

Note

Approval for this study was obtained from the Local Ethics Committee.


 

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