Open AccessNasal intermittent positive pressure ventilation in neonates with meconium aspiration syndrome
Author(s) -
Jagadish. A.S.,
Vikranth Vikranth,
B Ravichander
Publication year - 2020
Publication title -
pediatric review: international journal of pediatrics research
Language(s) - English
Resource type - Journals
eISSN - 2349-5499
pISSN - 2349-3267
DOI - 10.17511/ijpr.2020.i08.01
Subject(s) - medicine , meconium aspiration syndrome , meconium , univariate analysis , respiratory failure , ventilation (architecture) , mechanical ventilation , intermittent positive pressure ventilation , anesthesia , multivariate analysis , pregnancy , mechanical engineering , fetus , genetics , engineering , biology
Background: Nasal intermittent positive pressure ventilation ( NIPPV) as primary respiratorysupport in neonates with meconium aspiration syndrome (MAS) has not been studied. The presentstudy applied the use of NIPPV as a treatment modality in MAS and tried to identify factorspredicting NIPPV failure. Objective: The aim was to identify failure rates of MAS on NIPPV andpotential predictors of NIPPV failure. Design: Observational analytical study. Methods: 86 neonateswere admitted during the study period of 2 years of which 60 were included and NIPPV was appliedas the primary modality of respiratory support with available ventilators. Outcome variables werecompared between the MAS infants who failed NIPPV and those who were successfully managedwith NIPPV. Results: 7 neonates (11.7%) out of 60 enrolled neonates failed on NIPPV. There was asignificant decrease in Downe score, respiratory rate, heart rate, fio2 requirement after 6 hourscompared to a baseline measurement (p<0.01). On univariate analysis factors associated withNIPPV failure were high Fio2, high PEEP, at one hour of starting NIPPV (p<0.05). However, onlogistic regression none of the factors were predicting failure independently. Conclusion: NIPPVapplied early may reduce the need for mechanical ventilation in neonates with moderate to severeMAS.