Positive pressure ventilation in the newborn infant: The use of a face mask

doi:10.1016/S0022-3476(70)80163-9

The Journal of Pediatrics

Volume 76, Issue 2, February 1970, Pages 202-207

https://doi.org/10.1016/S0022-3476(70)80163-9 Get rights and content

Over an 18 month period, 118 infants have been ventilated with positive pressure. The need for intermittent positive pressure breathing (IPPB) was based on determinations of arterial blood gases or on prolonged apnea, neither of which were related to the outcome. Twenty-three infants survived (19.4 per cent). Only 8 per cent of infants weighing less than 1,500 grams lived, whereas the survival of infants weighing more than 1,500 grams was 40.5 per cent. It was possible to ventilate 96 of these infants with a face mask, as evidenced by a favorable change in blood gases. The use of a face mask has many advantages and the complications are minimal. It appears that the salvage of apneic infants was increased, but the over-all efficacy of IPPB is difficult to assess.

References (16)

AdamsonT.M. et al.
Mechanical ventilation in newborn infants with respiratory failure
Lancet
(1968)
StahlmanM.T. et al.
Negative pressure assisted ventilation in infants with hyaline membrane disease
J. Pediat.
(1970)
HeeseH. de V. et al.
Intermittent positive pressure ventilation in hyaline membrane disease
J. Pediat.
(1970)
ReesG.J. et al.
A technique of pulmonary ventilation with a nasotracheal tube
Brit. J. Anaesth.
(1966)
SymchychP. et al.
Squamous metaplasia and necrosis of the trachea complicating prolonged nasotracheal intubation of small newborn infants
J. Pediat.
(1967)
SwyerP.R.
An assessment of artificial respiration in the newborn
Delivoria-PapadopoulosM. et al.
Intermittent positive pressure respiration as a treatment in severe respiratory distress syndrome
Arch. Dis. Child.
(1965)
HeeseH. de V. et al.
Management of respiratory distress syndrome of the newborn with positive prressure respiration
S. Afr. Med. J.
(1963)

There are more references available in the full text version of this article.

Cited by (24)

Noninvasive respiratory support
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh Edition
50 Years Ago in THE JOURNAL OF PEDIATRICS: Commentary: The Use of Assisted Ventilation in the Therapy of Hyaline Membrane Disease
2020, Journal of Pediatrics
Nasal Intermittent Mandatory Ventilation Versus Nasal Continuous Positive Airway Pressure Before and After Invasive Ventilatory Support
2019, Clinics in Perinatology
Citation Excerpt :
NIPPV has been in use since the 1970s. In early observational reports, NIPPV resulted in favorable blood gas values.44 A small clinical trial followed in 1970, which found that NIPPV reduced need for, and increased time to, mechanical ventilation compared with head box but with unacceptable side effects when using the available interfaces.3
Non-invasive Respiratory Support
2017, Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care: Sixth Edition
Nasal intermittent positive pressure ventilation in preterm infants: Equipment, evidence, and synchronization
2016, Seminars in Fetal and Neonatal Medicine
Citation Excerpt :
NIPPV has been used as a form of non-invasive respiratory support in newborn infants since the 1970s [1]; however, uncertainty remains regarding its mechanism of action, and how best to apply it and in which infants.
The use of nasal intermittent positive pressure ventilation (NIPPV) as respiratory support for preterm infants is well established. Evidence from randomized trials indicates that NIPPV is advantageous over continuous positive airway pressure (CPAP) as post-extubation support, albeit with varied outcomes between NIPPV techniques. Randomized data comparing NIPPV with CPAP as primary support, and for the treatment of apnea, are conflicting. Intrepretation of outcomes is limited by the multiple techniques and devices used to generate and deliver NIPPV. This review discusses the potential mechanisms of action of NIPPV in preterm infants, the evidence from clinical trials, and summarizes recommendations for practice.
Non-invasive respiratory support of preterm neonates with respiratory distress: Continuous positive airway pressure and nasal intermittent positive pressure ventilation
2009, Seminars in Fetal and Neonatal Medicine
Citation Excerpt :
By contrast, neonatal NIPPV uses nasal prongs with variable leak and no flow trigger. Neonatal NIPPV was initially delivered via masks strapped tightly over the mouth and nose4,56,57 but the technique lost favour following reports of head moulding, cerebellar haemorrhages58 and gastrointestinal perforations.59 As very premature infants are now more likely to be extubated early, NIPPV is being re-introduced and new devices designed specifically to deliver synchronised NIPPV have been developed.
Non-invasive techniques of respiratory support were developed in order to reduce the adverse effects associated with ventilation via an endotracheal tube. Short bi-nasal prongs provide the most effective nasal interface for delivery of nasal continuous positive airway pressure (nCPAP). Devices used to generate CPAP include conventional ventilators, the ‘bubbly bottle’ system and the infant flow driver. NCPAP improves the rate of successful extubation. It is useful for preterm infants with respiratory distress syndrome, reducing time spent on an endotracheal tube and oxygen requirement at 28 d. However, nCPAP is associated with an increased rate of pneumothorax. Nasal intermittent positive pressure ventilation (NIPPV) is useful for augmenting the effectiveness of nCPAP. It further improves rates of successful extubation and shows promise as an initial method of respiratory support. Further research is required to determine the optimal settings for both nCPAP and NIPPV.

View all citing articles on Scopus

^**: Supported by Funds from the United States Public Health Service (NICHD Grant No. HD-00747 and Training Grant No. HD-0095).

^*: Reprint address: Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98105.

View full text

Positive pressure ventilation in the newborn infant: The use of a face mask**

Lancet

J. Pediat.

J. Pediat.

Brit. J. Anaesth.

J. Pediat.

An assessment of artificial respiration in the newborn

Intermittent positive pressure respiration as a treatment in severe respiratory distress syndrome

Arch. Dis. Child.

Management of respiratory distress syndrome of the newborn with positive prressure respiration

S. Afr. Med. J.