Synchronized nasal intermittent positive-pressure ventilation and neonatal outcomes
Vineet Bhandari, Neil N Finer, Richard A Ehrenkranz, Shampa Saha, Abhik Das, Michele C Walsh, William A Engle, Krisa P VanMeurs, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan Jobe, William Oh, Abbot R Laptook, Betty R Vohr, Angelita Hensman, Lucy Noel, Bonnie Stephens, Victoria E Watson, Teresa M Leach, Michele C Walsh, Avroy A Fanaroff, Deanne Wilson-Costello, Nancy S Newman, Bonnie S Siner, Duncan Neuhauser, Ronald N Goldberg, C Michael Cotten, Ricki Goldstein, Kathy Auten, Melody Lohmeyer, Barbara J Stoll, Ira Adams-Chapman, Susie Buchter, Ellen Hale, Marcia Bishop, Irma Seabrook, James A Lemons, Brenda B Poindexter, Anna M Dusick, William A Engle, Diana D Appel, Dianne Herron, Lucy Miller, Leslie Richard, Richard Hooper, Linda L Wright, Rosemary D Higgins, Elizabeth M McClure, W Kenneth Poole, Abhik Das, Betty Hastings, Elizabeth McClure, Jamie Newman, Rebecca L Perritt, Qing Yao, Carolyn Petrie Huitema, Kristin Zaterka-Baxter, David K Stevenson, Krisa P Van Meurs, Susan R Hintz, William D Rhine, M Bethany Ball, Carol Kibler, Jeffrey R Parker, Joan M Baran, Waldemar A Carlo, Ambalavanan Namasivayam, Myriam Peralta-Carcelen, Monica V Collins, Shirley S Cosby, Vivien Phillips, Neil N Finer, Yvonne E Vaucher, Maynard R Rasmussen, Paul R Wozniak, Greg Heldt, Kathy Arnell, Clarence Demetrio, Martha G Fuller, Chris Henderson, Wade Rich, Mindy Grabarczyk, Christina Joseph, Renee Bridge, Jim Goodmar, F Donovan, Kurt Schibler, Jean Steichen, Barb Alexander, Cathy Grisby, Marcia Mersmann, Holly Mincey, Jody Shively, Teresa Gratton, Charles R Bauer, Shahnaz Duara, Ruth Everett, Silvia Frade Eguaras, Silvia Fajardo-Hiriart, Dale L Phelps, Robert A Sinkin, Gary Myers, Linda Reubens, Diane Hust, Rosemary Jensen, Abbot R Laptook, Walid A Salhab, Charles R Rosenfeld, Roy J Heyne, Jackie F Hickman, Gay Hensley, Nancy A Miller, Janet Morgan, Melissa Martin, James Allen, Jon E Tyson, Kathleen Kennedy, Brenda H Morris, Pamela J Bradt, Laura L Whiteley, Esther G Akpa, Patty A Cluff, Anna E Lis, Georgia E McDavid, Nora I Alaniz, Patti L Tate, T Michael O'Shea, Robert G Dillard, Lisa Washburn, Nancy Peters, Barbara Jackson, Seetha Shankaran, Yvette Johnson, Athina Pappas, Rebecca Bara, Geraldine Muran, Deborah Kennedy, S Nadya Kazzi, Kim Hayes Hart, Maria Betts, Richard A Ehrenkranz, Patricia Gettner, Monica Konstantino, Elaine Romano, Vineet Bhandari, Neil N Finer, Richard A Ehrenkranz, Shampa Saha, Abhik Das, Michele C Walsh, William A Engle, Krisa P VanMeurs, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan Jobe, William Oh, Abbot R Laptook, Betty R Vohr, Angelita Hensman, Lucy Noel, Bonnie Stephens, Victoria E Watson, Teresa M Leach, Michele C Walsh, Avroy A Fanaroff, Deanne Wilson-Costello, Nancy S Newman, Bonnie S Siner, Duncan Neuhauser, Ronald N Goldberg, C Michael Cotten, Ricki Goldstein, Kathy Auten, Melody Lohmeyer, Barbara J Stoll, Ira Adams-Chapman, Susie Buchter, Ellen Hale, Marcia Bishop, Irma Seabrook, James A Lemons, Brenda B Poindexter, Anna M Dusick, William A Engle, Diana D Appel, Dianne Herron, Lucy Miller, Leslie Richard, Richard Hooper, Linda L Wright, Rosemary D Higgins, Elizabeth M McClure, W Kenneth Poole, Abhik Das, Betty Hastings, Elizabeth McClure, Jamie Newman, Rebecca L Perritt, Qing Yao, Carolyn Petrie Huitema, Kristin Zaterka-Baxter, David K Stevenson, Krisa P Van Meurs, Susan R Hintz, William D Rhine, M Bethany Ball, Carol Kibler, Jeffrey R Parker, Joan M Baran, Waldemar A Carlo, Ambalavanan Namasivayam, Myriam Peralta-Carcelen, Monica V Collins, Shirley S Cosby, Vivien Phillips, Neil N Finer, Yvonne E Vaucher, Maynard R Rasmussen, Paul R Wozniak, Greg Heldt, Kathy Arnell, Clarence Demetrio, Martha G Fuller, Chris Henderson, Wade Rich, Mindy Grabarczyk, Christina Joseph, Renee Bridge, Jim Goodmar, F Donovan, Kurt Schibler, Jean Steichen, Barb Alexander, Cathy Grisby, Marcia Mersmann, Holly Mincey, Jody Shively, Teresa Gratton, Charles R Bauer, Shahnaz Duara, Ruth Everett, Silvia Frade Eguaras, Silvia Fajardo-Hiriart, Dale L Phelps, Robert A Sinkin, Gary Myers, Linda Reubens, Diane Hust, Rosemary Jensen, Abbot R Laptook, Walid A Salhab, Charles R Rosenfeld, Roy J Heyne, Jackie F Hickman, Gay Hensley, Nancy A Miller, Janet Morgan, Melissa Martin, James Allen, Jon E Tyson, Kathleen Kennedy, Brenda H Morris, Pamela J Bradt, Laura L Whiteley, Esther G Akpa, Patty A Cluff, Anna E Lis, Georgia E McDavid, Nora I Alaniz, Patti L Tate, T Michael O'Shea, Robert G Dillard, Lisa Washburn, Nancy Peters, Barbara Jackson, Seetha Shankaran, Yvette Johnson, Athina Pappas, Rebecca Bara, Geraldine Muran, Deborah Kennedy, S Nadya Kazzi, Kim Hayes Hart, Maria Betts, Richard A Ehrenkranz, Patricia Gettner, Monica Konstantino, Elaine Romano
Abstract
Background: Synchronized nasal intermittent positive-pressure ventilation (SNIPPV) use reduces reintubation rates compared with nasal continuous positive airway pressure (NCPAP). Limited information is available on the outcomes of infants managed with SNIPPV.
Objectives: To compare the outcomes of infants managed with SNIPPV (postextubation or for apnea) to infants not treated with SNIPPV at 2 sites.
Methods: Clinical retrospective data was used to evaluate the use of SNIPPV in infants <or=1250 g birth weight (BW); and 3 BW subgroups (500-750, 751-1000, and 1001-1250 g, decided a priori). SNIPPV was not assigned randomly. Bronchopulmonary dysplasia (BPD) was defined as treatment with supplemental oxygen at 36 weeks' postmenstrual age.
Results: Overall, infants who were treated with SNIPPV had significantly lower mean BW (863 vs 964 g) and gestational age (26.4 vs 27.9 weeks), more frequently received surfactant (85% vs 68%), and had a higher incidence of BPD or death (39% vs 27%) (all P < .01) compared with infants treated with NCPAP. In the subgroup analysis, SNIPPV was associated with lower rates of BPD (43% vs 67%; P = .03) and BPD/death (51% vs 76%; P = .02) in the 500- to 750-g infants, with no significant differences in the other BW groups. Logistic regression analysis, adjusting for significant covariates, revealed infants with 500-700-g BW who received SNIPPV were significantly less likely to have the outcomes of BPD (OR: 0.29 [95% CI: 0.11-0.77]; P = .01), BPD/death (OR: 0.30 [95% CI: 0.11-0.79]; P = .01), neurodevelopmental impairment (NDI) (OR: 0.29 [95% CI: 0.09-0.94]; P = .04), and NDI/death (OR: 0.18 [95% CI: 0.05-0.62]; P = .006).
Conclusion: SNIPPV use in infants at greatest risk of BPD or death (500-750 g) was associated with decreased BPD, BPD/death, NDI, and NDI/death when compared with infants managed with NCPAP.
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Source: PubMed