A prospective randomized controlled trial of nasal bilevel positive airway pressure facilitating extubation in pre-mature infant with RDS / 临床儿科杂志

ABSTRACT

Objectives To assess the efifcacy of nasal bilevel positive airway pressure (nBiPAP) in preventing extuba-tion failure of neonatal respiratory distress syndrome (RDS) in premature infants. Methods Premature infants (≤32 weeks) diagnosed as RDS and treated with mechanical ventilation, admitted to the neonatal intensive care unit from January 2011 to June 2012, were enrolled in the prospective controlled trial. Fifty-six infants receiving non-invasive ventilation due to unrelieved expiratory dyspnea after the ifrst extubation were selected, and were randomly divided into nBiPAP group (n=27) and nCPAP group (n=29). Blood gas analysis before and after non-invasive ventilation, the failure rate of non-invasive venti-lation in seven days and the incidence of various complications were compared between two groups. Results The blood gas analysis for the ifrst time after extubation suggested that infants treated with nBiPAP had a higher PaO2 level ((58.7±6.3) vs. (55.1±5.9) mmHg, P<0.05) and lower PaCO2 level ((46.4±4.9) vs. (49.9±5.0) mmHg, P<0.05) than those treated with nCPAP. Infants treated with nBiPAP had lower incidence of extubation failure in seven days than infants treated with nCPAP (7.4%vs. 31.0%, P=0.042). The incidence of complications between two groups was similar. Conclusions nBiPAP is safe and fea-sible for preventing extubation failure in preterm infants≤32 weeks with RDS and is more effective than nCPAP.