To Study Effectiveness of Nasal Prong and Nasal Mask in Nasal Continuous Positive Airway Pressure in Preterm Neonates with Respiratory Distress

Gaurav, Kumar

doi:10.18535/jmscr/v5i5.32

Cited by 9 publications

(20 citation statements)

References 6 publications

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“…Selection bias: we scored low for the risk of selection bias for the six trials where the methodology was adequate 5‐8,12,23 . The methodology was unclear among the remainder trials (did not specify randomization [n = 3] 11,21,22 or allocation concealment methods [n = 3] 9,10,22 ).…”

Section: Resultsmentioning

confidence: 99%

“…Many clinical trials investigated the effect of NCPAP given via nasal masks compared with binasal prongs on the incidence of intubation within 72 hours. [5][6][7][8][9][10][11][12] However, only a few clinical trials showed NCPAP provided with nasal mask reduces the risk of intubation as compared with NCPAP given with binasal prongs. 8,12 Systematic reviews and meta-analyses of these clinical trials showed a similar benefit of reduced risk of intubation when NCPAP is provided with nasal masks compared with binasal prongs.…”

Section: Introductionmentioning

confidence: 99%

“…Many clinical trials investigated the effect of NCPAP given via nasal masks compared with binasal prongs on the incidence of intubation within 72 hours 5‐12 . However, only a few clinical trials showed NCPAP provided with nasal mask reduces the risk of intubation as compared with NCPAP given with binasal prongs 8,12 .…”

Section: Introductionmentioning

confidence: 99%

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Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants: A systematic review and meta‐analysis

Razak

Patel

2020

Pediatric Pulmonology

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Objective To investigate the effect of nasal continuous positive airway pressure (NCPAP) given with nasal masks (NM) compared with binasal prongs (BNP) on the incidence of intubation within 72 hours in preterm infants (primary outcome) via meta‐analysis of clinical studies. Data Sources We searched for randomized clinical trials (RCTs) or quasi‐RCTs in Medline, PubMed, and Web of Science from inception through 4 December 2019. Data Extraction/Synthesis Two independent co‐authors extracting data performed the meta‐analysis using a fixed‐effect model to yield pooled relative risk (RR) and its 95% confidence interval (CI) for each outcome. We used Cochrane GRADE to evaluate the evidence quality. Results Eleven RCTs met the inclusion criteria. The meta‐analysis showed NCPAP provided via NM significantly reduced the rate of intubation within 72 hours (RR, 0.72; 95% CI, 0.58‐0.90; nine studies; GRADE‐moderate) and nasal trauma (RR, 0.64; 95% CI, 0.55‐0.74; GRADE‐low) compared with NCPAP provided via BNP. Also, NCPAP via NM significantly reduced surfactant treatment (RR, 0.85; 95% CI, 0.74‐0.97; GRADE‐very low) and bronchopulmonary dysplasia (RR, 0.47; 95% CI, 0.23‐0.95; GRADE‐low) compared with BNP in a setting where NCPAP was used as the primary support in respiratory distress syndrome. No statistically significant differences were noted between groups in secondary outcomes except increased NCPAP duration when NCPAP given with NM compared with BNP (mean difference [days], 1.78; 95% CI, 1.67‐1.89; GRADE‐low). Conclusion Among premature infants, NCPAP provided with NM is more effective in preventing intubation and mechanical ventilation within 72 hours of initiating the support compared with NCPAP provided with BNP.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants: A systematic review and meta‐analysis

Razak

Patel

2020

Pediatric Pulmonology

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“…Recent in vivo studies comparing mask and short binasal prong interfaces have suggested that masks are similarly effective to prongs, and in some respects they may present an advantage 20–25. There are now five published randomised controlled trials comparing nasal masks and binasal prongs for CPAP administration in preterm infants.…”

Section: Discussionmentioning

confidence: 99%

“…Short binasal prongs are known to cause septal trauma, which was reduced with the use of nasal masks. However, masks have been associated with nasal bridge trauma 7 20 21 24 25. This has led to the current practice in many units of cycling between masks and prongs 7.…”

Section: Discussionmentioning

confidence: 99%

Assessment of resistance of nasal continuous positive airway pressure interfaces

Green

Dawson²,

Davis

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo compare the resistance of interfaces used for the delivery of nasal continuous positive airway pressure (CPAP) in neonates, as measured by the generated system pressure at fixed gas flows, in an in vitro setting.DesignGas flows of 6, 8 and 10 L/min were passed through three sizes of each of a selection of available neonatal nasal CPAP interfaces (Hudson prong, RAM Cannula, Fisher & Paykel prong, Infant Flow prong, Fisher & Paykel mask, Infant Flow mask). The expiratory limb was occluded and pressure differential measured using a calibrated pressure transducer.ResultsVariation in resistance, assessed by mean pressure differential, was seen between CPAP interfaces. Binasal prong interfaces typically had greater resistance at the smallest assessed sizes, and with higher gas flows. However, Infant Flow prongs produced low pressures (<1.5 cmH2O) at all sizes and gas flows. RAM Cannula had a high resistance, producing a pressure >4.5 cmH2O at all sizes and gas flows. Both nasal mask interfaces had low resistance at all assessed sizes and gas flows, with recorded pressure <1 cmH2O in all cases.ConclusionsThere is considerable variation in measured resistance of available CPAP interfaces at gas flows commonly applied in clinical neonatal care. Use of interfaces with high resistance may result in a greater drop in delivered airway pressure in comparison to set circuit pressure, which may have implications for clinical efficacy. Device manufacturers and clinicians should consider CPAP interface resistance prior to introduction into routine clinical care.

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Masks versus prongs as interfaces for nasal continuous positive airway pressure in preterm infants

Paoli

Oddie

Davis

et al. 2022

Cochrane Database of Systematic Reviews

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To Study Effectiveness of Nasal Prong and Nasal Mask in Nasal Continuous Positive Airway Pressure in Preterm Neonates with Respiratory Distress

Abstract: (112.5-354) in nasal prong group whereas nasal mask group median duration (IQR) of total hospital stay was 264 hrs .

Cited by 9 publications

References 6 publications

Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants: A systematic review and meta‐analysis

Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants: A systematic review and meta‐analysis

Assessment of resistance of nasal continuous positive airway pressure interfaces

Masks versus prongs as interfaces for nasal continuous positive airway pressure in preterm infants

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