Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants

Davis, Peter G; Henderson‐Smart, David J

doi:10.1002/14651858.cd000143

Cited by 260 publications

(170 citation statements)

References 11 publications

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“…Among the three studies evaluated by Davis et al in their meta-analysis, only one investigated the occurrence of apnea, and the results of which showed a tendency to reduce the episodes of apnea in premature infants randomized to nIPPV, although not statistically significant. 9 During the study period, whether in the nIPPV or nCPAP method, the occurrence of side effects was not observed, similar to that noted by other authors. 1,6,7,11,19 Barrington et al and Davis et al were unanimous in affirming that nIPPV is a useful and effective method to increase the benefits of nCPAP in the prevention of extubation failure of premature infants in the first hours after extubation.…”

Section: Discussionsupporting

confidence: 87%

“…However, early extubation has been accompanied by various difficulties, particularly due to instability of the ribcage, the presence of alveolar atelectasis and residual pulmonary damage. 9 Despite the non-invasive ventilation method used, the extubation failure rate was 23.6%, a similar result to those found in the literature. Barrington et al, in their controlled and randomized study, compared the extubation failure rate of 54 premature infants with BW < 1,250 g and GA of 26.1 weeks, verifying a failure rate of 29.6%.…”

Section: Discussionsupporting

confidence: 85%

“…17 Similar facts have been described by other authors. 9,18,19 Barrington et al did not demonstrate an increased incidence of abdominal distention or food intolerance in the 54 premature infants subject to two non-invasive ventilation methods, and also did not find any cases of gastric perforation. 1 A similar fact was described by Kiciman et al among the 14 premature infants studied.…”

Section: Discussionmentioning

confidence: 95%

“…These interventions include the use of nasal continuous positive airway pressure (nCPAP), 8,9 which has also demonstrated extubation failure at around 28% in newborns, which justifies the development and/or improvement of methods to increase its efficacy. 9 A new non-invasive, nasal method known as nasal intermittent positive pressure ventilation (nIPPV) has been used in extubated premature infants in order to decrease the incidence of extubation failure. This ventilation method seems to ensure better respiratory support, particularly in premature infants with VLBW, decreasing the need for tracheal re-intubation.…”

Section: Introductionmentioning

confidence: 99%

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Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

Komatsu

Diniz

Ferraro

et al. 2016

Rev. Assoc. Med. Bras.

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Objective:To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV) after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV) and continuous positive airway pressure (nCPAP). Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA) ≤ 36 weeks and birth weight (BW) > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6%) presented extubation failure in comparison to 11 (30.5%) of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

Komatsu

Diniz

Ferraro

et al. 2016

Rev. Assoc. Med. Bras.

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“…1 In preterm infants CPAP decreases the incidence and severity of apneas, reduces the degree of asynchronous breathing, and prevents reintubation following initial extubation. 2,3 One of the most common forms of CPAP currently used is the Infant Flow system (VIASYS) (IF-CPAP). With this device, gas flowing through nasal prongs is facilitated during exhalation via a fluidic-flip design.…”

Section: Introductionmentioning

confidence: 99%

Nasal continuous positive airway pressure from high flow cannula versus Infant Flow for preterm infants

et al. 2006

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Objective: To compare the feasibility of continuous positive airway pressure (CPAP) support generated by high flow nasal cannula with conventional CPAP for prevention of reintubation among preterm infants with a birth weight of p1250 g.Study Design: Preterm infants were randomized to CPAP generated via high flow cannula or the Infant Flow Nasal CPAP System (VIASYS, Conshohocken, PA, USA) at extubation. Primary outcome was incidence of reintubation within 7 days. Secondary outcomes included change in oxygen use and frequency of apnea and bradycardias postextubation.Results: Forty neonates were randomized. Twelve of 20 infants randomized to high flow cannula CPAP were reintubated compared to three of 20 using Infant Flow (P ¼ 0.003). The high flow cannula group had increased oxygen use and more apneas and bradycardias postextubation.Conclusions: CPAP delivered by high flow nasal cannula failed to maintain extubation status among preterm infants p1250 g as effectively as Infant Flow CPAP.

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Effects of Nasal Continuous Positive Airway Pressure and Cannula Use in the Neonatal Intensive Care Unit Setting

Jatana¹,

Oplatek²,

Stein³

et al. 2010

Arch Otolaryngol Head Neck Surg

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Objective To investigate the effects of nasal continuous positive airway pressure (CPAP) and cannula use in the neonatal intensive care unit. Design Cross-sectional study. Setting Tertiary care children’s hospital. Patients One hundred patients (200 nasal cavities), younger than 1 year, who received at least 7 days of nasal CPAP (n = 91) or cannula supplementation (n = 9) in the neonatal intensive care unit. Interventions External nasal examination and anterior nasal endoscopy with photographic documentation. Main Outcome Measures The incidence and characteristics of internal and external nasal findings of patients with nasal CPAP or cannula use. Results Nasal complications were seen in 12 of the 91 patients (13.2%) with at least 7 days of nasal CPAP exposure, while no complications were seen in the 9 patients with nasal cannula use alone. The external nasal finding of columellar necrosis, seen in 5 patients (5.5%), occurred as early as 10 days after nasal CPAP use. Incidence of intranasal findings attributed to CPAP use, in the 182 nostrils examined, included ulceration in 6 nasal cavities (3.3%), granulation in 3 nasal cavities (1.6%), and vestibular stenosis in 4 nasal cavities (2.2%). Intranasal complications were seen as early as 8 to 9 days after nasal CPAP administration. Nasal complications from CPAP were associated with lower Apgar scores at 1 (P = .02) and 5 (P = .06) minutes. Conclusions External or internal complications of nasal CPAP can be relatively frequent (13.2%) and can occur early, and patients with lower Apgar scores may be at higher risk. Close surveillance for potential complications should be considered during nasal CPAP use.

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Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants

Cited by 260 publications

References 11 publications

Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

Nasal continuous positive airway pressure from high flow cannula versus Infant Flow for preterm infants

Effects of Nasal Continuous Positive Airway Pressure and Cannula Use in the Neonatal Intensive Care Unit Setting

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