Nasal respiratory support in premature infants: short-term physiological effects and comfort assessment

Acta Paediatr. 2008 May;97(5):557-61. doi: 10.1111/j.1651-2227.2008.00732.x.


Aim: To evaluate the effects of nasal respiratory support on physiologic parameters and comfort of premature infants, when compared to spontaneous breathing without nasal respiratory support.

Methods: This was a prospective, randomized, controlled, cross-over clinical study. Infants were enrolled into the study when in 'stable' condition (when discontinuation of nasal respiratory support was considered appropriate). Infants were randomized to receive first 3 h of nasal respiratory support (nasal continuous positive airway pressure or nasal intermittent mandatory ventilation) or to spontaneous breathing, and then were crossed-over to the other assignment. Each infant served as his own control.

Results: Fifty-four infants were included in the study (birth-weight: 1528 +/- 545 g; gestational age: 30.5 +/- 2.7 weeks). Average values of systolic, diastolic and mean blood pressure and discomfort score were significantly higher while respiratory rate was significantly slower on nasal respiratory support compared to spontaneous breathing. Heart rate was comparable on both modes.

Conclusions: Nasal respiratory support in 'stable' premature infants is associated with increased blood pressure and increased discomfort, despite a decreased respiratory rate. The clinical importance of these effects is modest. Medical teams should consider these effects and balance its need with its adverse effects according to the clinical condition.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Apnea / etiology
  • Apnea / therapy*
  • Blood Pressure*
  • Continuous Positive Airway Pressure*
  • Cross-Over Studies
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Israel
  • Respiration*