Effect of Noninvasive Bi-Level Positive Pressure Ventilation Combined with Caffeine Citrate on Frequent Apnea in Premature Infants

2019 ◽  
Vol 08 (03) ◽  
pp. 222-226
Author(s):  
娜娜 黄
Keyword(s):  
Premature Infants ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Caffeine Citrate

scholarly journals Flow-Synchronized Nasal Intermittent Positive Pressure Ventilation for Infants <32 Weeks' Gestation with Respiratory Distress Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
C. Gizzi ◽  
P. Papoff ◽  
I. Giordano ◽  
L. Massenzi ◽  
C. S. Barbàra ◽  
...  
Keyword(s):  
Premature Infants ◽  
Positive Pressure Ventilation ◽  
Distress Syndrome ◽  
Clinical Course ◽  
Respiratory Acidosis ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Short Term ◽  
Postmenstrual Age ◽  
Surfactant Administration

Aim. To evaluate whether synchronized-NIPPV (SNIPPV) used after the INSURE procedure can reduce mechanical ventilation (MV) need in preterm infants with RDS more effectively than NCPAP and to compare the clinical course and the incidence of short-term outcomes of infants managed with SNIPPV or NCPAP.Methods. Chart data of inborn infants <32 weeks undergoing INSURE approach in the period January 2009–December 2010 were reviewed. After INSURE, newborns born January –December 2009 received NCPAP, whereas those born January–December 2010 received SNIPPV. INSURE failure was defined as FiO2need >0.4, respiratory acidosis, or intractable apnoea that occurred within 72 hours of surfactant administration.Results. Eleven out of 31 (35.5%) infants in the NCPAP group and 2 out of 33 (6.1%) infants in the SNIPPV group failed the INSURE approach and underwent MV (). Fewer infants in the INSURE/SNIPPV group needed a second dose of surfactant, a high caffeine maintenance dose, and pharmacological treatment for PDA. Differences in O2dependency at 28 days and 36 weeks of postmenstrual age were at the limit of significance in favor of SNIPPV treated infants.Conclusions. SNIPPV use after INSURE technique in our NICU reduced MV need and favorably affected short-term morbidities of our premature infants.

scholarly journals Effect of intermittent positive pressure ventilation on diastolic ventricular filling patterns in premature infants

1990 ◽  
Vol 16 (1) ◽  
pp. 171-174 ◽  
Author(s):  
Enrique Maroto ◽  
Jean-Claude Fouron ◽  
Georges Teyssier ◽  
Harry Bard ◽  
Nicolaas H. van Doesburg ◽  
...  
Keyword(s):  
Premature Infants ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Ventricular Filling

Effect of very early use of caffeine citrate in preterm neonates needing respiratory support

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hisham A Awad ◽  
ameh A Tawfik ◽  
Mariam JA Ibrahim ◽  
Bassem Hesham
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Positive Pressure Ventilation ◽  
Total Duration ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Positive Pressure ◽  
Early Group ◽  
Early Use ◽  
Caffeine Citrate

Abstract Background Caffeine citrate is one of the most widely used medications in neonatal intensive care units. It is a respiratory stimulant which has well established therapeutic effects in apnea and extubation. Little is known about the very early use of caffeine citrate in preterm neonates. We aim to explore the effectiveness of its very early use in reducing the duration of the respiratory support used and not just extubation. Objectives to study the effect of the very early use of caffeine citrate in preterm neonates on morbidity and short-term neonatal outcomes. Subjects and Methods A prospective phase 3 clinical trial was carried out on 54 preterm neonates less than 34 weeks of gestation who require respiratory support and were given caffeine citrate in two different settings, over a period of one year. Patients were randomly allocated to one of two groups, the first group was given caffeine citrate at initiation of respiratory support(CPAP, NIPPV and IPPV). The second group received caffeine citrate 6 hours before weaning of the respiratory support used. Caffeine citrate was stopped after complete removal of the respiratory support used. Both groups were compared as regard the duration of each respiratory support used separately and the total duration of respiratory support needed for each patient. Results The duration of IPPV used in patients was significantly lower in the patients that received early caffeine citrate. Total duration of the respiratory support needed for each patient was significantly lower in the early group. There was no significant difference in the development of complications related to the drug use between both groups. The total duration of NICU stay was significantly lower in the early group than the other group. Conclusion The Early initiation of caffeine citrate has effectively and safely decreased duration of respiratory support used and NICU stay without the development of any complications. Key words early caffeine citrate, preterm neonates, respiratory support. *CPAP: Continuous positive airway pressure NIPPV: Non invasive positive pressure ventilation IPPV: Intermittent positive pressure ventilation NICU: Neonatal Intensive care unit

scholarly journals Caffeine Citrate for the Prevention of Apnea Associated With Alprostadil Infusions

2020 ◽  
Vol 25 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Kristi L. Higgins ◽  
Marcia L. Buck
Keyword(s):  
Retrospective Study ◽  
Low Dose ◽  
Positive Pressure Ventilation ◽  
Time Frame ◽  
Small Sample ◽  
Positive Pressure ◽  
Control Group ◽  
Single Center ◽  
Caffeine Citrate ◽  
Dose Reductions

OBJECTIVE To evaluate the incidence of apnea and requirement for positive pressure ventilation in patients who received caffeine for prevention while receiving alprostadil compared with those who did not receive caffeine. METHODS This was a single-center, retrospective study of patients who received alprostadil over a 7-year time frame. Patients were divided into 2 groups based on whether they received caffeine for prevention of apnea while receiving alprostadil. The incidence of apnea and requirements for positive pressure ventilation were recorded. RESULTS A total of 64 patients who received alprostadil were included for review. Thirty-two patients received caffeine for the prevention of apnea, and 32 patients received alprostadil only. Alprostadil doses were similar between the 2 groups (0.04–0.05 mcg/kg/min). Seven patients had a documented apneic event; 3 in the group given caffeine and 4 in the control group. One patient in each group required intubation because of apnea. All patients with documented apnea were on low-dose alprostadil therapy (&lt;0.05 mcg/kg/min). Three patients had apnea after dose reductions had been made. Six out of the seven patients experienced apnea within the first 24 hours after the infusion. Only 1 patient experienced multiple apneic events. CONCLUSIONS In this small sample, there was no difference in incidence of apnea between patients on low-dose alprostadil who received caffeine for prevention and those who did not. Despite the use of low-dose alprostadil therapy and dose reductions, the incidence of apnea remains low, and most patients did not have repeated apneic events or require intubation.

scholarly journals Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

2016 ◽  
Vol 62 (6) ◽  
pp. 568-574 ◽  
Author(s):  
Daniela Franco Rizzo Komatsu ◽  
Edna Maria de Albuquerque Diniz ◽  
Alexandre Archanjo Ferraro ◽  
Maria Esther Jurvest Rivero Ceccon ◽  
Flávio Adolfo Costa Vaz
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Premature Infants ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Extubation Failure ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Summary Objective: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV) after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV) and continuous positive airway pressure (nCPAP). Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA) ≤ 36 weeks and birth weight (BW) > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6%) presented extubation failure in comparison to 11 (30.5%) of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

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