Nasal Intermittent Positive-Pressure Ventilation vs Nasal Continuous Positive Airway Pressure for Preterm Infants With Respiratory Distress Syndrome: A Systematic Review and Meta-analysis

JAMA Pediatrics, 04/05/2012

Meneses J et al. – Among preterm infants with respiratory distress syndrome, NIPPV decreases the need for invasive ventilation within the first 72hours of life compared with nasal continuous positive airway pressure (NCPAP). Trials are needed to assess whether nasal intermittent positive–pressure ventilation (NIPPV) minimizes the occurrence of bronchopulmonary dysplasia and other comorbidities.

Methods

  • MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov were searched, as well as abstracts from meetings of the Pediatric Academic Societies.
  • Randomized controlled trials involving infants with respiratory distress syndrome who received NIPPV vs NCPAP.
  • Data were extracted on the use of NIPPV vs NCPAP.
  • Also extracted were data on the need for invasive ventilation within the first 72hours of life and the incidences of bronchopulmonary dysplasia, pneumothorax, necrotizing enterocolitis, and intraventricular hemorrhage, as well as the time to full feeds and the duration of hospital stay.

Results

  • Three trials were included (n=360).
  • A significant decrease in the need for invasive ventilation was found in the NIPPV group (risk ratio, 0.60; 95% CI, 0.43-0.83).
  • No difference between groups was found in the incidence of bronchopulmonary dysplasia (risk ratio, 0.56; 95% CI, 0.09-3.49).
  • No differences in the other outcomes were observed between the 2 groups.

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