A trial comparing noninvasive ventilation strategies in preterm infants
Haresh Kirpalani, David Millar, Brigitte Lemyre, Bradley A Yoder, Aaron Chiu, Robin S Roberts, NIPPV Study Group, Koravangattu Sankaran, Laurentiu Givelichian, Cindy Thiel, Madan Roy, Haresh Kirpalani, Janice Cairnie, Elizabeth Asztalos, Marilyn Hyndman, Brigitte Lemyre, Jane Frank, Julie Barden, Robin Whyte, Alexandra A Howlett, Sharon Stone, Sajjad Rahman, Teresita B Calleja, Beeby Sara Joshua, Aaron Chiu, Ruben Alvaro, John Minski, Dayle Everatt, David Millar, David Sweet, Lorraine McGrory, Patricia McCreesh, Haresh Kirpalani, Aasma Chaudhary, Vadim Bronshtein, Mayan Bronshtein, Nadine Lahage, J V Aranda, Baldvin Jonsson, Lena Legnevall, Maneck Bhiladvala, Victor S Rajadurai, Thowfique Ibrahim, Pinchi S Srinivasan, Michael D Brandler, Piyush Jain, Bradley Yoder, Karen Osborne, Karie Bird, Cynthia Spencer, Jill Burnett, Kimberlee Weaver Lewis, Eugene M Dempsey, Ita Herlihy, Soraya Abbasi, Toni Mancini, Emidio Sivieri, Anne Twomey, Breda Coronella, Shanthy Sridhar, Rose McGovern, Elaine Boyle, Marie Hubbard, Rosalind Astles, Patrick McNamara, Michael Finelli, Andrea Tkachuk, Corinna D'Souza, Jenny Luc, Sunit V Godambe, Peter C M Chow, Peter H Dijk, Richard A van Lingen, Diny van Zoeren-Grobben, Liesbeth J M Groot Jebbink, Kabir Abubakar, Munish Gupta, Rosanne Buck, Mary Quinn, Nina Koyama, Pierre Maton, Anne François, Jean-Paul Langhendries, Arnaud Marguglio, Wivinne Marion, Sophie Smeets, Jane Ierardi, Jan Miletin, Anne O'Sullivan, Ivan D Frantz 3rd, Brenda Mackinnon, Ellen Nylen, Sukhvinder Ranu, Roger Kim, Dominique Jean-Baptiste, Myron Sokal, Pradeep Siwach, Preeti Bimbrahw, Ram Gobburu, Praveen Chandrasekharan, Qi Rong, Jagdish Desai, Sri Narayana, Anu Garg, Sashi Kumar Kona, Mumun Rawat, Wolfgang Stelzl, Burkhard Simma, Ivan Hand, Berndt Urlesberger, Friedrich Reiterer, Gerhard Pichler, Kelly Vaillancourt, Maureen Meade, Shelley Monkman, Vineet Bhandari, Henry Halliday, Reese Clark, Rollin Brant, Robin S Roberts, Haresh Kirpalani, Lorrie Costantini, Harvey Nelson, Bronwyn Gent, Haresh Kirpalani, David Millar, Brigitte Lemyre, Bradley A Yoder, Aaron Chiu, Robin S Roberts, Haresh Kirpalani, David Millar, Brigitte Lemyre, Bradley A Yoder, Aaron Chiu, Robin S Roberts, NIPPV Study Group, Koravangattu Sankaran, Laurentiu Givelichian, Cindy Thiel, Madan Roy, Haresh Kirpalani, Janice Cairnie, Elizabeth Asztalos, Marilyn Hyndman, Brigitte Lemyre, Jane Frank, Julie Barden, Robin Whyte, Alexandra A Howlett, Sharon Stone, Sajjad Rahman, Teresita B Calleja, Beeby Sara Joshua, Aaron Chiu, Ruben Alvaro, John Minski, Dayle Everatt, David Millar, David Sweet, Lorraine McGrory, Patricia McCreesh, Haresh Kirpalani, Aasma Chaudhary, Vadim Bronshtein, Mayan Bronshtein, Nadine Lahage, J V Aranda, Baldvin Jonsson, Lena Legnevall, Maneck Bhiladvala, Victor S Rajadurai, Thowfique Ibrahim, Pinchi S Srinivasan, Michael D Brandler, Piyush Jain, Bradley Yoder, Karen Osborne, Karie Bird, Cynthia Spencer, Jill Burnett, Kimberlee Weaver Lewis, Eugene M Dempsey, Ita Herlihy, Soraya Abbasi, Toni Mancini, Emidio Sivieri, Anne Twomey, Breda Coronella, Shanthy Sridhar, Rose McGovern, Elaine Boyle, Marie Hubbard, Rosalind Astles, Patrick McNamara, Michael Finelli, Andrea Tkachuk, Corinna D'Souza, Jenny Luc, Sunit V Godambe, Peter C M Chow, Peter H Dijk, Richard A van Lingen, Diny van Zoeren-Grobben, Liesbeth J M Groot Jebbink, Kabir Abubakar, Munish Gupta, Rosanne Buck, Mary Quinn, Nina Koyama, Pierre Maton, Anne François, Jean-Paul Langhendries, Arnaud Marguglio, Wivinne Marion, Sophie Smeets, Jane Ierardi, Jan Miletin, Anne O'Sullivan, Ivan D Frantz 3rd, Brenda Mackinnon, Ellen Nylen, Sukhvinder Ranu, Roger Kim, Dominique Jean-Baptiste, Myron Sokal, Pradeep Siwach, Preeti Bimbrahw, Ram Gobburu, Praveen Chandrasekharan, Qi Rong, Jagdish Desai, Sri Narayana, Anu Garg, Sashi Kumar Kona, Mumun Rawat, Wolfgang Stelzl, Burkhard Simma, Ivan Hand, Berndt Urlesberger, Friedrich Reiterer, Gerhard Pichler, Kelly Vaillancourt, Maureen Meade, Shelley Monkman, Vineet Bhandari, Henry Halliday, Reese Clark, Rollin Brant, Robin S Roberts, Haresh Kirpalani, Lorrie Costantini, Harvey Nelson, Bronwyn Gent, Haresh Kirpalani, David Millar, Brigitte Lemyre, Bradley A Yoder, Aaron Chiu, Robin S Roberts
Abstract
Background: To reduce the risk of bronchopulmonary dysplasia in extremely-low-birth-weight infants, clinicians attempt to minimize the use of endotracheal intubation by the early introduction of less invasive forms of positive airway pressure.
Methods: We randomly assigned 1009 infants with a birth weight of less than 1000 g and a gestational age of less than 30 weeks to one of two forms of noninvasive respiratory support--nasal intermittent positive-pressure ventilation (IPPV) or nasal continuous positive airway pressure (CPAP)--at the time of the first use of noninvasive respiratory support during the first 28 days of life. The primary outcome was death before 36 weeks of postmenstrual age or survival with bronchopulmonary dysplasia.
Results: Of the 497 infants assigned to nasal IPPV for whom adequate data were available, 191 died or survived with bronchopulmonary dysplasia (38.4%), as compared with 180 of 490 infants assigned to nasal CPAP (36.7%) (adjusted odds ratio, 1.09; 95% confidence interval, 0.83 to 1.43; P=0.56). The frequencies of air leaks and necrotizing enterocolitis, the duration of respiratory support, and the time to full feedings did not differ significantly between treatment groups.
Conclusions: Among extremely-low-birth-weight infants, the rate of survival to 36 weeks of postmenstrual age without bronchopulmonary dysplasia did not differ significantly after noninvasive respiratory support with nasal IPPV as compared with nasal CPAP. (Funded by the Canadian Institutes of Health Research; NIPPV ClinicalTrials.gov number, NCT00433212; Controlled-Trials.com number, ISRCTN15233270.).
Source: PubMed