Nasal Intermittent Positive-Pressure Ventilation Offers No Advantages Over Nasal Continuous Positive Airway Pressure in Apnea of Prematurity

Ca, Ryan; Nn, Finer; Kl, Peters

doi:10.1001/archpedi.1989.02150220094026

Cited by 55 publications

(60 citation statements)

References 14 publications

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“…Este número mostra-se superior ao de estudos semelhantes, como o estudo exposto em Ryan CA et al 13 , o qual encontrou que, das 17 unidades investigadas no Canadá, apenas 9 (53%) faziam uso de VPPIN, e o de Owen et al 9 , no qual se observou que somente 48% das unidades neonatais inglesas utilizavam a VPPIN. Contudo, não podemos fazer uma inferência desta informação para a atualidade, considerando-se o número crescente de publicações sobre o assunto com reflexo no aumento da utilização desta modalidade pelas diversas instituições nacionais e internacionais.…”

Section: Discussionunclassified

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Medeiros¹,

Carvalho²,

Soriano³

2012

J Pediatr (Rio J)

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Objective: To investigate the use of nasal intermittent positive pressure ventilation (NIPPV) in level three neonatal intensive care units (NICU) in northeastern Brazil. Methods:This observational cross-sectional survey was conducted from March 2009 to January 2010 in all level three NICUs in northeastern Brazil that are registered in the Brazilian Registry of Health Establishments (Cadastro Nacional de Estabelecimentos de Saúde, CNES) of the Ministry of Health. Questionnaires about the use of NIPPV were sent to the NICU directors in each institution. Statistical analysis was conducted using the software Epi-Info 6.04 and double data entry. A chi-square test was used to compare variables, and the level of statistical significance was set at p ≤ 0.05. Results: This study identified 93 level three NICUs in northeasternBrazil registered in CNES, and 87% answered the study questionnaire. ResumoObjetivo: Conhecer as práticas referentes ao uso de ventilação por pressão positiva intermitente nasal (VPPIN) em unidades terciárias de atendimento neonatal do Nordeste brasileiro.Métodos: Estudo observacional seccional tipo inquérito, realizado entre março de 2009 e janeiro de 2010 em todas as instituições de atendimento neonatal de nível terciário localizadas no Nordeste brasileiro, cadastradas no Conselho Nacional dos Estabelecimentos de Saúde (CNES) do Ministério de Saúde. Realizado por meio de levantamento, utilizando questionários sobre o uso de VPPIN, enviados aos responsáveis das unidades de cuidados intensivos neonatais de cada instituição. A análise estatística foi realizada pelo software Epi-Info versão 6.04, com dupla entrada de dados. As variáveis foram comparadas pelo teste do qui-quadrado, sendo considerado nível de significância de 5%.Resultados: Estão cadastradas no CNES 93 unidades terciárias neonatais no Nordeste brasileiro. Os questionários foram respondidos por 87% delas. A maior parte classificou-se como de natureza privada (30,7%) ou pública estadual (29,4%). O número de instituições que se utilizam da VPPIN correspondeu a 98,7% do total. Grande parte das unidades (92,8 %) declarou utilizar aparelhos de ventilação pulmonar mecânica, adaptados para aplicação de VPPIN, e pronga binasal curta como interface (94,2%). O protocolo para aplicação de VPPIN existia em apenas 17,3% das unidades. A média dos valores de pressão positiva inspiratória adotados foi de 20,0 cmH 2 O (desvio padrão = 4,47) e de pressão expiratória final positiva foi de 5,0 cmH 2 O (desvio padrão = 0,84). Conclusão:A VPPIN representa um suporte utilizado pelas unidades neonatais no Nordeste brasileiro, embora se observe pouca uniformização quanto às indicações e parâmetros adotados entre as instituições. J Pediatr (Rio J). 2012;88(1):48-53:Respiração artificial, neonatologia, unidade de terapia intensiva, recém-nascido. Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

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Section: Discussionunclassified

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Medeiros¹,

Carvalho²,

Soriano³

2012

J Pediatr (Rio J)

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“…1, 10,11 Although there are few studies on the use of nIPPV, most research consists of a small number of newborns and/or observation for a short period after extubation. 1,7,12 Method Sample Seventy-two newborns were studied, all with a GA ≤ 36 weeks and 6 days and BW > 750 g, and respiratory failure requiring orotracheal intubation and mechanical ventilation at the Unidade de Cuidados Intensivos Neonatal, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP) and the Unidade de Terapia Intensiva Neonatal, Hospital Estadual Mário Covas de Santo André (UTIN HESA).…”

Section: Introductionmentioning

confidence: 99%

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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“…Two studies compared NIPPV vs NCPAP for the treatment of apnea of prematurity. 29,30 Although meta-analysis was not possible, one trial showed a reduction in apnea frequency with NIPPV and the other a trend favoring NIPPV. 23 …”

Section: Strategizing (S)nippvmentioning

confidence: 99%

Nasal intermittent positive pressure ventilation in the newborn: review of literature and evidence-based guidelines

Bhandari

2009

J Perinatol

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Nasal Intermittent Positive-Pressure Ventilation Offers No Advantages Over Nasal Continuous Positive Airway Pressure in Apnea of Prematurity

Cited by 55 publications

References 14 publications

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

Practices of use of nasal intermittent positive pressure ventilation (NIPPV) in neonatology in northeastern Brazil

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

Nasal intermittent positive pressure ventilation in the newborn: review of literature and evidence-based guidelines

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