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Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial
Journal article   Peer reviewed

Noninvasive Ventilation in Newborns ≤ 1,500 g after Tracheal Extubation: Randomized Clinical Trial

Simone Nascimento Santos Ribeiro, Maria Jussara Fernandes Fontes, Vineet Bhandari, Camilla Borges Resende and Cintia Johnston
American journal of perinatology, v 34(12), pp 1190-1198
Oct 2017
PMID: 28420011

Abstract

Original Article
Abstract Objective  Our aim was to compare the success of extubation in neonates managed with nonsynchronized intermittent nasal positive-pressure ventilation (nsNIPPV) and two modes of nasal continuous positive airway pressure (NCPAP) after the first extubation. Study Design  Randomized controlled clinical trial conducted in the neonatal intensive care unit (NICU) included infants with gestational age ≤ 34 weeks and birth weights (BW) 500 to 1,500 g with a diagnosis of respiratory distress syndrome (RDS), divided into three groups: ventilation with nsNIPPV, bubble-NCPAP, and ventilator-NCPAP. Extubation failure (EF) was defined as occurring within 48 hours after extubation. Results  We included 101 newborns: nsNIPPV ( n  = 36); bubble-NCPAP ( n  = 32) ventilator-NCPAP ( n  = 33). Overall, the extubation success rate was 81.2%. There were no skin, gastric, or pulmonary complications related to noninvasive ventilation (NIV) ( p  = 1). There was no difference between the groups regarding the success/EF ( p  = 0.4). There was extubation success in 81 (81.2%) cases, and EF occurred in 20 (19.8%), associated with longer invasive mechanical ventilation time ( p  < 0.001) and development of bronchopulmonary dysplasia ( p  = 0.04). Conclusion  In this trial, three modalities of NIV applied in the success/failure outcomes of extubation avoided reintubation in 80% of infants.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Obstetrics & Gynecology
Pediatrics
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