IPPV Doesn't Beat CPAP in Very-Low-Birth-Weight Preemies
(HealthDay News) – For extremely-low-birth-weight infants, survival to 36 weeks of gestational age is not significantly different with use of noninvasive respiratory support with nasal intermittent positive-pressure ventilation (IPPV) or nasal continuous positive airway pressure (CPAP), according to a study published in the Aug. 15 issue of the New England Journal of Medicine.
Haresh Kirpalani, BM, MSc, from the Children's Hospital of Philadelphia, and colleagues randomized 1,009 infants with a birth weight of <1,000g and a gestational age of <30 weeks to IPPV (data available for 497 infants) or nasal CPAP (490 infants). Death before 36 weeks of postmenstrual age or survival without bronchopulmonary dysplasia was the primary outcome.
The researchers found that 38.4% of infants assigned to IPPV and 36.7% assigned to nasal CPAP died or survived with bronchopulmonary dysplasia (P=0.56). There were no significant differences between the groups in the frequency of air leaks and necrotizing enterocolitis, duration of respiratory support, and time to full feeding.
"In summary, among high-risk preterm infants eligible for noninvasive modes of respiratory support during the first month of life, nasal IPPV was not superior to nasal CPAP with respect to survival without bronchopulmonary dysplasia at 36 weeks of postmenstrual age," the authors write. "No other clinically important outcomes differed significantly between groups."