Non-invasive respiratory support of preterm neonates with respiratory distress: continuous positive airway pressure and nasal intermittent positive pressure ventilation

Semin Fetal Neonatal Med. 2009 Feb;14(1):14-20. doi: 10.1016/j.siny.2008.08.003. Epub 2008 Oct 4.


Non-invasive techniques of respiratory support were developed in order to reduce the adverse effects associated with ventilation via an endotracheal tube. Short bi-nasal prongs provide the most effective nasal interface for delivery of nasal continuous positive airway pressure (nCPAP). Devices used to generate CPAP include conventional ventilators, the 'bubbly bottle' system and the infant flow driver. NCPAP improves the rate of successful extubation. It is useful for preterm infants with respiratory distress syndrome, reducing time spent on an endotracheal tube and oxygen requirement at 28d. However, nCPAP is associated with an increased rate of pneumothorax. Nasal intermittent positive pressure ventilation (NIPPV) is useful for augmenting the effectiveness of nCPAP. It further improves rates of successful extubation and shows promise as an initial method of respiratory support. Further research is required to determine the optimal settings for both nCPAP and NIPPV.

MeSH terms

  • Continuous Positive Airway Pressure* / adverse effects
  • Continuous Positive Airway Pressure* / instrumentation
  • Continuous Positive Airway Pressure* / methods
  • Delivery Rooms
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intermittent Positive-Pressure Ventilation* / adverse effects
  • Intermittent Positive-Pressure Ventilation* / instrumentation
  • Intermittent Positive-Pressure Ventilation* / methods
  • Intubation, Intratracheal
  • Pulmonary Surfactants / therapeutic use
  • Respiratory Distress Syndrome, Newborn / therapy*


  • Pulmonary Surfactants