Noninvasive Option Allows Preterm Infants to Breathe Freely

Prevention of ARDS critical to survival, avoiding long-term conditions

A new study appearing in the journal CHEST® suggests that treatment with nasal high-frequency oscillatory ventilation (NHFOV) is a beneficial management strategy in preterm infants, and is superior to nasal continuous positive airway pressure (NCPAP) in preventing reintubation.

Preterm infants with respiratory distress syndrome (RDS) face heightened risks of death, critical illness, and prolonged hospitalization, particularly if they progress to develop acute respiratory distress syndrome (ARDS).

“To our knowledge, this is the first study comparing NHFOV with NCPAP as post-extubation respiratory support modes in preterm infants with neonatal ARDS,” explained lead investigator Yuan Shi, PhD, MD, FAAP, of the Children’s Hospital of Chongqing Medical University in Chongqing, China. “Usually, one of the most important causes of reintubation is difficulty in clearing the partial pressure of carbon dioxide (PCO2). We found that NHFOV was superior to NCPAP in reducing PCO2 levels.”

The randomized trial enrolled over 200 infants born at less than 37 weeks’ gestation. Of these infants, 61.7 percent were diagnosed with RDS, 25.7 percent with ARDS, and 12.6 percent with both RDS and ARDS. The rate of reintubation in the group receiving NCPAP was more than twice as high compared to infants who received NHFOV (34.0 percent vs. 15.5 percent.)

SOURCE: Science Daily