Initial treatment of respiratory distress syndrome with nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure: a randomized controlled trial
IJPM-International Journal of Preventive Medicine. 2014; 5 (12): 1543-1551
en Inglés
| IMEMR
| ID: emr-167680
ABSTRACT
Neonatal respiratory distress syndrome [RDS] in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation [MV] nowadays researchers in interested minimizing MV. To determine, in very low birth weight [BW] preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation [early NIMV] compared with early nasal continuous positive airway pressure [early NCPAP] obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. In this single-center randomized control trial study, infants [BW = 1500 g and/or gestational age = 34 weeks] with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO[2] requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. 98 infants were enrolled [44 in the NIMV and 54 in the NCPAP group]. The Preventive power of MV of NIMV usage [95.5%] was not lower than the NCPAP [98.1%] strength [hazard ratio 0.21 [95% confidence interval 0.02-2.66]; P 0.23]. The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP [the median [range] was 24 [18.00-48.00] h versus 48.00 [22.00-120.00] h in NIMV versus NCPAP groups; P < 0.001]. Similarly, the duration of dependency on oxygen was less, for NIMV [the median [range] was 96.00 [41.00-504.00] h versus144.00 [70.00-1130.00] h in NIMV versus NCPAP groups; P 0.009]. Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group
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Índice:
IMEMR (Mediterraneo Oriental)
Asunto principal:
Surfactantes Pulmonares
/
Recién Nacido
/
Recien Nacido Prematuro
/
Ventilación con Presión Positiva Intermitente
/
Presión de las Vías Aéreas Positiva Contínua
Tipo de estudio:
Ensayo Clínico Controlado
Límite:
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. J. Prev. Med.
Año:
2014
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