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Nasal continuous positive airway pressure (NCPAP) or noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) for preterm infants with respiratory distress after birth: A randomized controlled trial
Author(s) -
Yagui Ana C.,
Meneses Jucille,
Zólio Bianca A.,
Brito Gabriela M. G.,
da Silva Rafael Justino,
Rebello Celso M.
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24466
Subject(s) - medicine , bronchopulmonary dysplasia , continuous positive airway pressure , respiratory distress , anesthesia , mechanical ventilation , randomized controlled trial , population , intubation , positive airway pressure , respiratory failure , ventilation (architecture) , gestational age , surgery , pregnancy , mechanical engineering , genetics , environmental health , engineering , obstructive sleep apnea , biology
Objectives To compare rates of treatment failure between the use of nasal continuous positive airway pressure (NCPAP) and noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) in infants with respiratory distress after birth. Methods A randomized, unblinded, double‐center trial was conducted in infants with birth weights (BWs) less than or equal to 1500 g and respiratory distress receiving noninvasive respiratory support for less than or equal to 48 hours of life; some infants were initially treated with minimally invasive surfactant therapy as the standard of care. Primary outcome: need for endotracheal intubation with use of mechanical ventilation (MV) at less than or equal to 72 hours of life using prespecified failure criteria. Secondary outcomes: use of surfactant, duration of noninvasive support, duration of MV, bronchopulmonary dysplasia (BPD) and death. Results A total of 123 infants were included (NCPAP group = 64 and NIV‐NAVA group = 59). Population characteristics were similar between groups. No difference in the primary outcome was observed: NCPAP = 10 (15.6%) and NIV‐NAVA = 12 (20.3%), P = .65. Groups were also similar in the use of surfactant (19 vs 17), duration of noninvasive support (147 ± 181 hours vs 127 ± 137 hours), BPD incidence and death. However, duration of MV was significantly longer in NCPAP group (95.6 ± 45.8 hours vs 28.25 ± 34.1 hour), P = .01. Conclusion In infants with respiratory distress after birth, no differences in treatment failures were observed between NIV‐NAVA and NCPAP. These results require further evaluation in a larger study.