Randomized trial of mask or prongs for nasal intermittent mandatory ventilation in term infants with transient tachypnea of the newborn

• Published in: Pediatrics international 2020-04, Vol.62 (4), p.484-491
• Main Authors: Ilhan, Ozkan, Bor, Meltem
• Format: Article
• Language: English
• Subjects: Birth weight; Female; Gestational Age; Humans; Incidence; Infant, Newborn; Infants; Intermittent Positive-Pressure Ventilation - instrumentation; Intermittent Positive-Pressure Ventilation - methods; Intolerance; Intubation; Intubation - statistics & numerical data; Length of Stay - statistics & numerical data; Male; Masks; Mechanical ventilation; nasal intermittent mandatory ventilation; nasal mask; nasal prong; Neonates; Newborn babies; Nose; Oxygen Inhalation Therapy - statistics & numerical data; Pediatrics; Pneumonia - epidemiology; Pneumothorax; Pneumothorax - epidemiology; Prospective Studies; Respiration; Respiratory Distress Syndrome, Newborn - therapy; Risk Factors; Statistical analysis; Supplements; transient tachypnea of newborn; Transient Tachypnea of the Newborn - therapy; Trauma; Treatment Outcome
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.14104

Background The aim of this study was to compare nasal masks (NM) with binasal prongs (NP) for applying nasal intermittent mandatory ventilation (NIMV) by assessing the duration of respiratory distress, rate of intubation, and nasal trauma in term infants with transient tachypnea of the newborn (TTN). Methods Infants with a gestational age ≥37 weeks and birthweight ≥2,000 g who had NIMV administered for TTN were enrolled. We randomly allocated 80 neonates to the NM (n = 40) or NP (n = 40) group. Duration of respiratory distress was the primary outcome of this study. Results There were no statistically significant differences between the groups for the duration of tachypnea and NIMV (P = 0.94 and P = 0.13, respectively). No significant differences were observed between the two groups in terms of duration of oxygen supplementation and length of hospitalization (P = 0.72 and P = 0.70, respectively). The incidence of any grade of trauma and moderate trauma (grade II) was significantly higher in the NP group than in the NM group (P = 0.004 and P = 0.04, respectively). The rate of NIMV failure and other complications, including pneumothorax, pneumonia and feeding intolerance, was not significantly different in the groups. Conclusions In term infants with TTN, delivering NIMV using NP in comparison to using NM appears to be similar with regard to the duration of respiratory distress and preventing intubation. However, the use of NP involves a greater risk of trauma than that of NM.