RT Journal Article SR Electronic T1 Response of Preterm Infants to 2 Noninvasive Ventilatory Support Systems: Nasal CPAP and Nasal Intermittent Positive-Pressure Ventilation JF Respiratory Care FD American Association for Respiratory Care SP 1772 OP 1776 DO 10.4187/respcare.03565 VO 60 IS 12 A1 Carmen Salum Thomé Silveira A1 Kamila Maia Leonardi A1 Ana Paula Carvalho Freire Melo A1 José Eduardo Zaia A1 Marisa Afonso Andrade Brunherotti YR 2015 UL http://rc.rcjournal.com/content/60/12/1772.abstract AB BACKGROUND: Noninvasive ventilation (NIV) in preterm infants is currently applied using intermittent positive pressure (2 positive-pressure levels) or in a conventional manner (one pressure level). However, there are no studies in the literature comparing the chances of failure of these NIV methods. The aim of this study was to evaluate the occurrence of failure of 2 noninvasive ventilatory support systems in preterm neonates over a period of 48 h.METHODS: A randomized, prospective, clinical study was conducted on 80 newborns (gestational age < 37 weeks, birthweight < 2,500 g). The infants were randomized into 2 groups: 40 infants were treated with nasal CPAP and 40 infants with nasal intermittent positive-pressure ventilation (NIPPV). The occurrence of apnea, progression of respiratory distress, nose bleeding, and agitation was defined as ventilation failure. The need for intubation and re-intubation after failure was also observed.RESULTS: There were no significant differences in birth characteristics between groups. Ventilatory support failure was observed in 25 (62.5%) newborns treated with nasal CPAP and in 12 (30%) newborns treated with NIPPV, indicating an association between NIV failure and the absence of intermittent positive pressure (odds ratio [OR] 1.22, P < .05). Apnea (32.5%) was the main reason for nasal CPAP failure. After failure, 25% (OR 0.33) of the newborns receiving nasal CPAP and 12.5% (OR 0.14) receiving NIPPV required invasive mechanical ventilation.CONCLUSIONS: Ventilatory support failure was significantly more frequent when nasal CPAP was used.