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[Non-invasive mandatory ventilation in extremely low birth weight and very low birth weight newborns with failed

Witold Lesiuk1, Leszek Lesiuk, Marta Maliczowska

  • 1Kliniczny Oddział Anestezjologii i Intensywnej Terapii Dzieciecego Szpitala Klinicznego im. Profesora Antoniego Gebali 20-093 Lublin, ul. Dr W. Chodzki 2. lesiukw@dsk.lublin.pl

Przeglad Lekarski
|July 11, 2002
PubMed

Insights

Early extubation benefits extremely low birth weight (ELBW) infants, but failure is common. Nasal intermittent mandatory ventilation (NIMV) effectively reduces apnea of prematurity, improving outcomes without endotracheal intubation risks.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology

Context:

  • Extubation in extremely low birth weight (ELBW) and very low birth weight (VLBW) infants receiving invasive mechanical ventilation (IMV) is associated with significant risks.
  • These risks include tracheal/laryngeal injury, nosocomial infections, and bronchopulmonary dysplasia (BPD).
  • Prematurity-related factors like apnea, hypoventilation, and atelectasis increase extubation failure rates in this vulnerable population.

Purpose:

  • To evaluate the effectiveness of noninvasive nasal intermittent mandatory ventilation (NIMV) in managing apnea of prematurity.
  • To assess the risk of abdominal distension associated with NIMV in ELBW and VLBW infants.

Summary:

  • Nasal intermittent mandatory ventilation (NIMV) was employed to provide noninvasive respiratory support for premature infants experiencing apnea.
  • A study involving 32 patients demonstrated that NIMV significantly reduced the incidence of apnea of prematurity in nearly all cases.
  • Effective oxygenation (SaO2) and carbon dioxide levels (pCO2) were achieved, obviating the need for endotracheal intubation.

Impact:

  • NIMV facilitates successful extubation, mitigating the risks of endotracheal tube-associated complications such as nosocomial pneumonia.
  • This noninvasive approach helps prevent the development or worsening of bronchopulmonary dysplasia (BPD).
  • While NIMV offers advantages, potential drawbacks like gastric distension due to air trapping require careful consideration.

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