Abstract | BACKGROUND: METHODS: We performed a selective literature search in PubMed including randomized controlled trials (RCT) (n ≥ 200) and meta-analyses published in the field of NIV in neonatology and follow-up studies focusing on long term pulmonary and neurodevelopmental outcomes. RESULTS: Individual studies do not show a significant risk reduction for the combined endpoint death or BPD in preterm infants caused by early CPAP in RDS when compared to primary intubation. One meta-analysis comparing four studies found CPAP significantly reduces the risk of BPD or death (relative risk: 0.91; 95% confidence interval [0.84;0.99]). Nasal intermittent positive pressure ventilation (NIPPV) as a primary ventilation strategy reduces the rate of intubations in infants with RDS (RR: 0.78 [0.64;0.94]) when compared to CPAP but does not affect the rate of BPD (RR: 0.78 [0.58;1.06]). CONCLUSION: Early CPAP reduces the need for IMV and the risk of BPD or death in preterm infants with RDS. NIPPV may offer advantages over CPAP regarding intubation rates. Networking-based follow-up programs are required to assess the effect of NIV on long term pulmonary and neurodevelopmental outcomes.
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Authors | Judith Behnke, Brigitte Lemyre, Christoph Czernik, Klaus-Peter Zimmer, Harald Ehrhardt, Markus Waitz |
Journal | Deutsches Arzteblatt international
(Dtsch Arztebl Int)
Vol. 116
Issue 11
Pg. 177-183
(03 08 2019)
ISSN: 1866-0452 [Electronic] Germany |
PMID | 31014448
(Publication Type: Journal Article, Review)
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Topics |
- Continuous Positive Airway Pressure
- Humans
- Infant, Newborn
- Infant, Premature
- Intermittent Positive-Pressure Ventilation
(methods)
- Meta-Analysis as Topic
- Neonatology
- Noninvasive Ventilation
(methods)
- Randomized Controlled Trials as Topic
- Respiratory Distress Syndrome, Newborn
(therapy)
- Treatment Outcome
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