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Neonatal nasal intermittent positive pressure ventilation: what do we know in 2007?
  1. Louise S Owen,
  2. Colin J Morley,
  3. Peter G Davis
  1. Neonatal Services, Royal Women’s Hospital
    Carlton, Victoria, Australia
  1. Dr Louise Owen, Neonatal Research Fellow, Royal Women’s Hospital, Grattan Street, Carlton, VIC 3053, Australia; louise.owen{at}rwh.org.au

Abstract

Although neonatal nasal intermittent positive pressure ventilation (NIPPV) is widely used today, its place in neonatal respiratory support is yet to be fully defined. Current evidence indicates that NIPPV after extubation of very premature infants reduces the rate of reintubation. However, much is still not known about NIPPV including its mechanisms of action. It may improve pulmonary mechanisms, tidal volume and minute ventilation but more studies are required to confirm these findings. There is some evidence that NIPPV marginally improves gas exchange. More research is needed to establish which device is best, what settings to use or whether to use synchronised rather than non-synchronised NIPPV, and about the way to wean NIPPV. Future studies should enrol sufficient infants to detect uncommon serious complications and include long-term follow up to determine important neurodevelopment and pulmonary outcomes.

  • nasal ventilation
  • NIPPV
  • non-invasive
  • neonatal
  • respiratory

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Footnotes

  • Competing interests: None.

  • Abbreviations:
    CLD
    chronic lung disease
    CPAP
    continuous positive airway pressure
    nCPAP, nasal continuous positive airway pressure
    NIPPV
    nasal intermittent positive pressure ventilation
    PEEP
    positive end expiratory pressure
    PIP
    positive inspiratory pressure
    sNIPPV
    synchronised nasal intermittent positive pressure ventilation

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