Strategies To Improve Respiratory Outcomes In Premature Infants With Respiratory Distress Syndrome

Abstract

Infants born prematurely with respiratory distress syndrome (RDS) are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with two different types of continuous positive airway pressure (CPAP). A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, Level III neonatal intensive care unit. A sample of 194 premature infants with RDS were selected, 124 of whom were treated with nasal intermittent positive pressure ventilation (NIPPV) and 70 with bilevel variable flow CPAP (SiPAP). Infants in both groups had high extubation success rates (79% of NIPPV group and 77% of SiPAP group). Although infants in the SiPAP group were extubated sooner, there was no difference in duration of oxygen therapy between the two groups. This study is the first to compare SiPAP and NIPPV on the outcome of extubation success. The study provides important evidence of the high extubation success rates that are possible with the use of SiPAP and NIPPV post-extubation. Another promising finding was that infants treated with SiPAP were extubated sooner than those treated with NIPPV. Promoting early extubation and extubation success are vital strategies to reduce complications of mechanical ventilation that adversely affect premature infants with RDS.