Effect of different modalities of noninvasive respiratorys upport in preterm infants with respiratory distress syndrome: A prospective multicenter study

Background The first few hours after birth are very critical for newborns to adapt to the extrauterine environment. However, respiratory distress syndrome (RDS) is very common in newborns, particularly in those with shorter gestation ages, sepsis, and fewer platelet counts. The evaluation of respiratory management with current noninvasive ventilation (NIV) support strategies in preterm infants present within the neonatal intensive care unit, as well as drawbacks of NIV modes including nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation, and high-flow nasal cannula, is also critical for those patients. This study aimed to compare different modes of NIV to highlight the preferred respiratory support model for preterm infants with RDS and to assess the advantages of NIV such as decreasing ventilator-induced lung injury to highlight the best model for NIV. Patients and methods A total of 120 babies were randomly divided into three equal groups in four neonatal intensive care units. Each group was treated with one type of NIV immediately after birth. Demographic data and clinical, laboratory, and radiographic measures were collected. Moreover, the use of surfactant/caffeine, optimum humidification, and appropriate nasal interface were recorded. Results The nasal intermittent positive pressure ventilation mode revealed a higher preference with different risk factors; however, a significant association between better survival and heated humidified high-flow nasal cannula mode was also revealed. Moreover, intubation decreased in neonates with feeding intolerance, abdominal distention, and pressure necrosis by about 27, 87, and 13%, respectively (P > 0.05)