Original articleNasal Intermittent Mandatory Ventilation Versus Nasal Continuous Positive Airway Pressure for Respiratory Distress Syndrome: A Randomized, Controlled, Prospective Study
Section snippets
Procedure
This was a prospective, open, controlled, single-center, clinical trial comparing the effectiveness of NCPAP and NIMV in the treatment of RDS. RDS was defined in the presence of clinical features and a positive chest x-ray film. The study was approved by the institutional review board in our center. All the parents signed informed consent before participating in the study. Endotracheal intubation was performed in the delivery room if the heart rate did not increase to >100 beats/min, or if the
Results
Of 232 infants born <35 weeks during the study period, 10 infants were excluded (1 infant because of hydrops fetalis, 1 infant because of esophageal atresia and tracheoesophageal fistula, 1 infant because of unstable clinical condition caused by sepsis and disseminated intravascular coagulation, 3 infants because of no available respirator with synchronized NIMV, 2 infants because of lack of parental consent, and 2 infants who started on nasal support without prior randomization). Of the
Discussion
We found that NIMV was more successful than NCPAP as the initial treatment of RDS in premature infants (<35 weeks) by reducing the rate of endotracheal ventilation. This was associated with a reduced incidence of BPD.
To our knowledge, there are no previous published studies that assessed whether NIMV or NCPAP is preferred in the initial treatment of RDS. However, a few studies have found that NIMV was superior to NCPAP post extubation, after mechanical ventilation and surfactant treatment, for
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