Safety of bubble nasal intermittent positive pressure ventilation (NIPPV) versus bubble nasal continuous positive airway pressure (NCPAP) in preterm infants with respiratory distress

J Perinatol. 2024 Sep;44(9):1252-1257. doi: 10.1038/s41372-024-01904-8. Epub 2024 Feb 15.

Abstract

Objective: Nasal Intermittent Positive Pressure Ventilation (NIPPV) is an effective therapy for infants in respiratory distress. We here report the safety of a novel, low-cost, non-electric bubble NIPPV device in comparison with bubble NCPAP.

Study design: At Paramitha Children's Hospital (Hyderabad, India), preterm (n = 60) neonates with moderate respiratory distress were pragmatically allocated to bubble NCPAP (5-8 cm H2O) or bubble NIPPV (Phigh 8-12 cm H2O/Plow 5-8 cm H2O) based on staff and equipment availability. Primary outcomes to assess safety included clinically relevant pneumothorax, nasal septal necrosis, or abdominal distention.

Results: One patient in each arm developed minor nasal septal injury (grade 3 on NCPAP, grade 2 on NIPPV); no patients in either arm developed a clinically significant pneumothorax or abdominal distention.

Conclusion: The similar rates of nasal septal injury, pneumothorax and abdominal distention suggest that bubble NIPPV has a similar safety profile as bubble NCPAP for preterm infants in respiratory distress.

Publication types

  • Comparative Study

MeSH terms

  • Continuous Positive Airway Pressure* / adverse effects
  • Continuous Positive Airway Pressure* / methods
  • Female
  • Humans
  • India
  • Infant, Newborn
  • Infant, Premature*
  • Intermittent Positive-Pressure Ventilation* / adverse effects
  • Intermittent Positive-Pressure Ventilation* / methods
  • Male
  • Nasal Septum
  • Pneumothorax / etiology
  • Pneumothorax / therapy
  • Respiratory Distress Syndrome, Newborn* / therapy