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Published on: November 30, 2022
A randomized controlled trial of synchronized nasal intermittent positive pressure ventilation in RDS
V Bhandari1, R G Gavino, J H Nedrelow
1Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, PA, USA. vineet.bhandari@yale.edu
Summary
Synchronized nasal intermittent positive pressure ventilation (SNIPPV) reduces bronchopulmonary dysplasia (BPD)/death in premature infants with respiratory distress syndrome (RDS) compared to conventional ventilation (CV). Early extubation to SNIPPV is a feasible and effective strategy.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Critical Care
Background:
- Respiratory distress syndrome (RDS) is a common condition in premature infants.
- Conventional ventilation (CV) can lead to complications like bronchopulmonary dysplasia (BPD).
- Alternative ventilation strategies are needed to improve outcomes for infants with RDS.
Purpose of the Study:
- To compare the outcomes of infants with RDS treated with synchronized nasal intermittent positive pressure ventilation (SNIPPV) versus conventional ventilation (CV) after surfactant administration.
- To evaluate the efficacy of early extubation to SNIPPP in reducing BPD/death in premature infants.
Main Methods:
- A prospective, randomized controlled trial was conducted.
- Infants with birth weights between 600 and 1250 g and RDS received surfactant.
- Infants were then randomized to either primary mode SNIPPV or continued CV.
Main Results:
- The SNIPPV group showed a significantly lower incidence of BPD/death (20%) compared to the CV group (52%, P=0.03).
- No significant differences were observed in maternal demographics, infant characteristics, or other neonatal morbidities between the groups.
- Follow-up assessments revealed no differences in Mental or Psychomotor Developmental Index scores.
Conclusions:
- Early extubation to SNIPPV following surfactant administration significantly reduces the incidence of BPD/death in premature infants with RDS.
- Primary mode SNIPPV is a feasible and effective ventilation method for small premature infants.
- SNIPPV offers a promising alternative to CV for managing RDS in this vulnerable population.
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