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Nasal intermittent positive pressure ventilation as a rescue therapy after nasal continuous positive airway pressure failure in infants with respiratory distress syndrome

Journal of Perinatology volume 43, pages 311–316 (2023)Cite this article

Subjects

Abstract

Objective

Evaluate whether nasal intermittent positive-pressure ventilation (NIPPV) as rescue therapy after initial nasal continuous positive airway (NCPAP) failure reduces need for invasive mechanical ventilation (IMV) in infants with respiratory distress syndrome (RDS).

Design

Retrospective cohort involving 156 preterm infants who failed initial NCPAP and were then submitted to NIPPV rescue therapy and classified into NIPPV success or failure, according to need for IMV.

Result

Of all infants included, 85 (54.5%) were successfully rescued with NIPPV while 71 (45.5%) failed. The NIPPV success group had significantly lower rates of bronchopulmonary dysplasia, peri/intraventricular hemorrhage, patent ductus arteriosus and greater survival without morbidities (all p ≤ 0.01). Infants who failed NIPPV had earlier initial NCPAP failure (p = 0.09). In final logistic regression model, birthweight ≤1000 g and need for surfactant remained significant factors for NIPPV failure.

Conclusion

NIPPV rescue therapy reduced the need for IMV in infants that failed NCPAP and was associated with better outcomes.

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Fig. 1: Flowchart of the study.
Fig. 2: Kaplan Meier Survival Curve.

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Data availability

The authors acknowledge that the data and materials are available to referees at submission and to readers promptly upon request.

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Author information

Authors and Affiliations

  1. Division of Neonatology, Instituto de Medicina Integral Professor Fernando Figueira, IMIP, Recife, Brazil

    Ana Catarina Ishigami, Jucille Meneses, João Guilherme Alves, Juliana Carvalho & Emídio Cavalcanti

  2. Division of Neonatology, The Children’s Regional Hospital at Cooper, Camden, NJ, USA

    Vineet Bhandari

  3. Cooper Medical School of Rowan University, Camden, NJ, USA

    Vineet Bhandari

Authors
  1. Ana Catarina Ishigami
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  6. Vineet Bhandari
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Contributions

CI conceptualized the study, participated in the study design, data collection and data analysis, and wrote and revised the paper. JM conceptualized the study, participated in the study design and data analysis, and wrote and revised the paper. JA participated in the study design, data analysis and revision. JC participated in the study design and data collection. EA participated in the data analysis. VB conceptualized the study, participated in the study design, and revised the paper.

Corresponding author

Correspondence to Jucille Meneses.

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The authors declare no competing interests.

Ethics approval and consent to participate

The research complied with the ethical principles established in the Declaration of Helsinki and was submitted to the ethics committee of the Instituto de Medicina Integral Professor Fernando Figueira, IMIP, Recife, Brazil. CAAE: 27431919.0.0000.5201.

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Ishigami, A.C., Meneses, J., Alves, J.G. et al. Nasal intermittent positive pressure ventilation as a rescue therapy after nasal continuous positive airway pressure failure in infants with respiratory distress syndrome. J Perinatol 43, 311–316 (2023). https://doi.org/10.1038/s41372-023-01600-z

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