scholarly journals Three non-invasive ventilation strategies for preterm infants with respiratory distress syndrome: a propensity score analysis

2020 ◽  
Vol 16 (6) ◽  
pp. 1319-1326
Author(s):  
Huiling Cao ◽  
Huanhuan Li ◽  
Xingwang Zhu ◽  
Li Wang ◽  
Ming Yi ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Malakian ◽  
Mohammad Reza Aramesh ◽  
Mina Agahin ◽  
Masoud Dehdashtian

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.


2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.


2021 ◽  
pp. 18-21
Author(s):  
Ahmet Özdemir ◽  
Mustafa Ali Akın ◽  
Osman Baştug ◽  
Tamer Güneş

The aim of the present study was to compare the efficacy of leak compensated nasal SIMV (LCnSIMV) and leak synchronized nasal SIMV (LSnSIMV) modes in order to reduce the need for endotracheal intubation and associated complications in newborns with respiratory distress. This randomized, prospective study was conducted on 50 infants (25 per group) with gestational age below 34 weeks and/or below 2000 grams who have been admitted to NICU of Erciyes University Hospital because of respiratory distress syndrome (RDS) and need for mechanical ventilation. Infants with congenital heart disease, nasopharyngeal pathology (coanal atresia and cleft palate-lip) were excluded. Infants monitored on mechanical ventilator after surfactant were randomly assigned to LCnSIMV and LSnSIMV groups before extubation. SPO2/FiO2 (S/F), peak heart rate (PHR), respiration rate per minute (RRM), and arterial blood pressure (aBP) values of patients were recorded. Gestational age, birth weight, gender, RDS, patent ductus arteriosus (PDA) requiring treatment, presence of intraventricular bleeding (IVH), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) were recorded. The patients enrolled in the study were female by 48% and male by 52%. There was not any statistically significant difference between groups for gender, postnatal age and birth weight. There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for non-invasive ventilation period and re-intubation rate (p=0.04 and p=0.03, respectively). There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for SpO2 and S/F rates at 60 minutes (p=0.03 and p=0.01, respectively). There was not any difference between groups for blood pressure, PDA, IVH, ROP, BPD, NEC, sepsis and air leak. It may be appropriate to prefer the LSnSIMV method in patients with respiratory distress syndrome who need non-invasive ventilation in the pre-extubation period by considering the patient-ventilator compliance for positive effect in terms of mechanical clinical variables.


Medicine ◽  
2021 ◽  
Vol 100 (4) ◽  
pp. e24443
Author(s):  
Mohamad Y. Khatib ◽  
Mohamed Z. Peediyakkal ◽  
Moustafa S. Elshafei ◽  
Hani S. Elzeer ◽  
Dore C. Ananthegowda ◽  
...  

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