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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Unsynchronized Nasal Intermittent Positive Pressure Ventilation to prevent extubation failure in neonates: a
Mala Kumar1, Shalini Avasthi, Shruti Ahuja
1C-83, Nirala Nagar, Lucknow 226020, India. mala_lko@yahoo.co.in
Indian Journal of Pediatrics
|February 3, 2011
Summary
Unsynchronized Nasal Intermittent Positive Pressure Ventilation (NIPPV) significantly reduces extubation failure in preterm neonates. This simple noninvasive ventilation method showed a 47% reduction in failure rates without serious side effects.
Area of Science:
- Neonatal Intensive Care
- Respiratory Support
- Pediatric Critical Care
Background:
- Mechanical ventilation is crucial for preterm neonates but carries risks of extubation failure.
- Preterm infants weighing less than 2,000 g are particularly vulnerable to respiratory complications post-extubation.
- Noninvasive ventilation strategies are sought to improve outcomes in this population.
Purpose of the Study:
- To assess the efficacy of Unsynchronized Nasal Intermittent Positive Pressure Ventilation (NIPPV) in preventing extubation failure.
- To evaluate NIPPV's role in mechanically ventilated preterm neonates (<2,000 g).
Main Methods:
- Randomized controlled trial in a tertiary care neonatal intensive care unit.
- Included preterm neonates (<2,000 g) ventilated for >24 hours.
- Compared NIPPV with a shortened endotracheal tube versus head box oxygen (50% FiO2).
Main Results:
- Extubation failure rate was significantly lower in the NIPPV group (16%) compared to the control group (63%) (RR=0.25; p=0.00).
- NIPPV demonstrated a 47% reduction in extubation failure within 72 hours.
- No serious side effects were observed with NIPPV, though total hospital stay was not reduced.
Conclusions:
- Unsynchronized Nasal Intermittent Positive Pressure Ventilation is an effective and simple noninvasive technique.
- NIPPV significantly decreases extubation failure rates in preterm neonates.
- The method is safe and does not appear to cause serious adverse events.
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