Clinical Course of Apnoeic Preterm Infants with Moderate Respiratory Distress Syndrome (RDS) Undergoing Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) vs Nasal Bi-Level CPAP (SIPAP): A RCT Study

Mancuso, Diego Attilio; Lista, Gianluca; Castoldi, Francesca; Lupo, Enrica; Cavigioli, Franco

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BACKGROUND: Non invasive approaches to neonatal RDS are becoming increasingly popular. Apnoea episodes may influence efficacy of these methods. Little is known about Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) and Bi-level Nasal Continuous Positive Airway Pressure (Bi-level NCPAP) in the acute phase of moderate RDS. OBJECTIVE: To evaluate the need of mechanical ventilation of preterm infants with moderate RDS and apnoea episodes, randomly assigned at 1 hour of life to NSIMV or to Bi-level NCPAP. DESIGN/METHODS: 16 infants (27-32 wks GA), with moderate RDS (a/ApO2 0,2-0,3) assisted from birth with NCPAP (PEEP = 5-6 cmH2O) but presenting > 4 apnoea episodes or > 2 severe apnoea episodes despite of caffeine therapy, were considered eligible and randomly assigned at 1 hour of life to NSIMV (I.T. 0,35 sec, RR 30/min, PEEP 5 cmH2O, PIP 20 cmH2O Group A n=8) (Giulia Neonatal Nasal Ventilator-Ginevri srl Italy) or to Bi-level NCPAP (Time High 1sec, RR 30/min, lower CPAP level 5 cmH2O; higher CPAP level 9 cmH2O, Group B n=8) (Infant Flow SiPAP™ -Viasys Healthcare CA). Intubation took place in case of persistent apnea and/or worsening of RDS despite of INSURE. Need of mechanical ventilation, lenght of respiratory support, oxygen need, occurrence of air leak or gastrointestinal perforation, enteral feeding initiation and length of hospital stay were recorded. RESULTS: Infants had similar characteristics at birth (GA 30.5 ±1,3 v. 30.3±1,8 wks, BW 1251±303 v. 1294±439g, Apgar score at 5' 8,3±1 vs 8,1±0,8, antenatal steroids 7/8 vs 7/8, Gr A vs Gr B). No differences of length of respiratory support, O2 dependency, starting of enteral feeding or lenght of hospital stay. No intubation plus mechanical ventilation was needed. No gastrointestinal perforations, nasal trauma, PNX, BPD or neurological disorders occurred. CONCLUSIONS: Bi-level NCPAP and NSIMV used as respiratory support in neonates with moderate RDS and apnoea episodes were efficacious in preventing mechanical ventilation and showed same short term respiratory outcomes. E-PAS2010808

Mancuso, D. A., Lista, G., Castoldi, F., Lupo, E., Cavigioli, F., Clinical Course of Apnoeic Preterm Infants with Moderate Respiratory Distress Syndrome (RDS) Undergoing Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) vs Nasal Bi-Level CPAP (SIPAP): A RCT Study, Poster paper, in Atti del Congresso “PAS 2010 – Pediatric Academic Societies”, (VANCOVER, 01-04 May 2010), PAS, Vancouver 2010: 808-808 [http://hdl.handle.net/10807/13219]

Autori:	Mancuso, Diego Attilio Lista, Gianluca Castoldi, Francesca Lupo, Enrica Cavigioli, Franco Mostra autori esterni Nascondi autori esterni
Titolo:	Clinical Course of Apnoeic Preterm Infants with Moderate Respiratory Distress Syndrome (RDS) Undergoing Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) vs Nasal Bi-Level CPAP (SIPAP): A RCT Study
Data di pubblicazione:	2010
Abstract:	BACKGROUND: Non invasive approaches to neonatal RDS are becoming increasingly popular. Apnoea episodes may influence efficacy of these methods. Little is known about Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) and Bi-level Nasal Continuous Positive Airway Pressure (Bi-level NCPAP) in the acute phase of moderate RDS. OBJECTIVE: To evaluate the need of mechanical ventilation of preterm infants with moderate RDS and apnoea episodes, randomly assigned at 1 hour of life to NSIMV or to Bi-level NCPAP. DESIGN/METHODS: 16 infants (27-32 wks GA), with moderate RDS (a/ApO2 0,2-0,3) assisted from birth with NCPAP (PEEP = 5-6 cmH2O) but presenting > 4 apnoea episodes or > 2 severe apnoea episodes despite of caffeine therapy, were considered eligible and randomly assigned at 1 hour of life to NSIMV (I.T. 0,35 sec, RR 30/min, PEEP 5 cmH2O, PIP 20 cmH2O Group A n=8) (Giulia Neonatal Nasal Ventilator-Ginevri srl Italy) or to Bi-level NCPAP (Time High 1sec, RR 30/min, lower CPAP level 5 cmH2O; higher CPAP level 9 cmH2O, Group B n=8) (Infant Flow SiPAP™ -Viasys Healthcare CA). Intubation took place in case of persistent apnea and/or worsening of RDS despite of INSURE. Need of mechanical ventilation, lenght of respiratory support, oxygen need, occurrence of air leak or gastrointestinal perforation, enteral feeding initiation and length of hospital stay were recorded. RESULTS: Infants had similar characteristics at birth (GA 30.5 ±1,3 v. 30.3±1,8 wks, BW 1251±303 v. 1294±439g, Apgar score at 5' 8,3±1 vs 8,1±0,8, antenatal steroids 7/8 vs 7/8, Gr A vs Gr B). No differences of length of respiratory support, O2 dependency, starting of enteral feeding or lenght of hospital stay. No intubation plus mechanical ventilation was needed. No gastrointestinal perforations, nasal trauma, PNX, BPD or neurological disorders occurred. CONCLUSIONS: Bi-level NCPAP and NSIMV used as respiratory support in neonates with moderate RDS and apnoea episodes were efficacious in preventing mechanical ventilation and showed same short term respiratory outcomes. E-PAS2010808
Lingua:	Inglese
Titolo del libro:	Atti del Congresso “PAS 2010 – Pediatric Academic Societies”
Editore:	PAS
Nome del convegno:	PAS 2010 Pediatric Academic Societies - Annual Meeting
Luogo del convegno:	VANCOVER
Data inizio evento:	2010-05-01
Data fine evento:	2010-05-04
Tipo di contributo:	Poster paper
Citazione:	Mancuso, D. A., Lista, G., Castoldi, F., Lupo, E., Cavigioli, F., Clinical Course of Apnoeic Preterm Infants with Moderate Respiratory Distress Syndrome (RDS) Undergoing Nasal Syncronized Intermittent Mandatory Ventilation (NSIMV) vs Nasal Bi-Level CPAP (SIPAP): A RCT Study, Poster paper, in Atti del Congresso “PAS 2010 – Pediatric Academic Societies”, (VANCOVER, 01-04 May 2010), PAS, Vancouver 2010: 808-808 [http://hdl.handle.net/10807/13219]
Appare nelle tipologie:	Paper, Selected paper, Contributed paper, Working paper, Poster, Poster paper, Comunicazione, Relazione (in volume)

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