Predictors for Nasal Intermittent Positive Pressure Ventilation Failure for Premature Infants With Respiratory Distress Syndrome

Ankara City Hospital

Status: Completed

Conditions: Premature; Respiratory Distress Syndrome, Newborn

Treatments: Other: non-invasive ventilation

Study type: Observational

Funder types: Other

Identifiers

NCT05260424

E1-20-1250

Details and patient eligibility

About

Non-invasive respiratory support methods have been widely used in premature babies with respiratory distress syndrome (RDS) which has changed the basic management of premature babies in the early period. According to the 2019 European Guidelines on RDS management, early nasal CPAP is recommended as first-line therapy in infants <30 weeks of age who are at risk of RDS who do not require mechanical ventilation (MV). However, some of the premature babies have faced non-invasive ventilation failure. Remarkably, infants who experience non-invasive ventilation failure are at increased risk of death, pneumothorax, intraventricular hemorrhage, and bronchopulmonary dysplasia (BPD), among other morbidities. In non-invasive ventilation failure, although demographic factors such as small gestational age, low birth weight, and male gender play a role, it has been suggested that surfactant deficiency may also play an important role. The most frequently reported risk factor in predicting non-invasive failure in studies is the fraction of inspiring oxygen during the first hours of life. In addition, positive end-expiratory airway pressure (PEEP) required for patient stabilization was found to be a potential predictor. However, there are still limited data to predict non-invasive ventilation failure. "Which newborns are at high risk for non-invasive ventilation failure?" and "When should the surfactant be applied?". The study is a single-center, prospective study to evaluate prognostic factors, and most importantly to define the FiO2 threshold, which is an indicator of possible non-invasive ventilation failure in infants supported with nasal intermittent positive pressure ventilation.

Enrollment: 397 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• <32 weeks preterm babies
• Those who have received nasal intermittent positive pressure ventilation

Exclusion criteria

• Babies born> 32 weeks
• Babies with congenital anomalies
• Babies who have intubated in the delivery room
• Babies whose parents refuse to participitate

Trial design

397 participants in 2 patient groups

non-invasive ventilation failure

Description:

babies who will be intubated in the first 72 hours

Treatment:

Other: non-invasive ventilation

non-invasive ventilation success

Description:

babies who will not intubated in the first 72 hours

Treatment:

Other: non-invasive ventilation