Nasal continuous positive airway pressure (NCPAP) or noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) for preterm infants with respiratory distress after birth: A randomized controlled trial

摘要

Abstract Objectives To compare rates of treatment failure between the use of nasal continuous positive airway pressure (NCPAP) and noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) in infants with respiratory distress after birth. Methods A randomized, unblinded, double‐center trial was conducted in infants with birth weights (BWs) less than or equal to 1500?g and respiratory distress receiving noninvasive respiratory support for less than or equal to 48?hours of life; some infants were initially treated with minimally invasive surfactant therapy as the standard of care. Primary outcome: need for endotracheal intubation with use of mechanical ventilation (MV) at less than or equal to 72?hours of life using prespecified failure criteria. Secondary outcomes: use of surfactant, duration of noninvasive support, duration of MV, bronchopulmonary dysplasia (BPD) and death. Results A total of 123 infants were included (NCPAP group?=?64 and NIV‐NAVA group?=?59). Population characteristics were similar between groups. No difference in the primary outcome was observed: NCPAP?=?10 (15.6%) and NIV‐NAVA?=?12 (20.3%), P ?=?.65. Groups were also similar in the use of surfactant (19 vs 17), duration of noninvasive support (147?±?181?hours vs 127?±?137?hours), BPD incidence and death. However, duration of MV was significantly longer in NCPAP group (95.6?±?45.8?hours vs 28.25?±?34.1?hour), P ?=?.01. Conclusion In infants with respiratory distress after birth, no differences in treatment failures were observed between NIV‐NAVA and NCPAP. These results require further evaluation in a larger study.