Nasal CPAP and BiPAP as the Initial Respiratory Support in Preterm Infants: A Randomized Controlled Trial Nasales CPAP und BiPAP als initiale Atemunterstützung bei Frühgeborenen: Eine randomisierte kontrollierte Studie

ARAYICI S., Simsek G. K., Say B., Oncel M. Y., Sari F. N., Uras N., ...Daha Fazla

Klinische Padiatrie, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1055/a-2546-1381
  • Dergi Adı: Klinische Padiatrie
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts
  • Anahtar Kelimeler: Bi-level positive airway pressure, Nasal continuous positive airway pressure, Non-invasive respiratory support, Respiratory distress syndrome, Surfactant
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Objective This study aimed to compare the nasal continuous positive airway pressure (nCPAP) and bi-level positive airway pressure (BiPAP) in preterm infants with respiratory distress syndrome (RDS). Method Preterm infants (≤32 weeks of gestation) were randomly assigned, at birth, into two study groups: nCPAP or BiPAP. Primary outcomes (surfactant administration and failure of non-invasive respiratory support within the first 72 hours), and secondary outcomes (duration of ventilation support, pneumothorax, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, intraventricular haemorrhage, retinopathy of prematurity, time to total enteral feeding, length of hospital stay, and mortality) were assessed. Results A total of 188 preterm infants with RDS were analysed. Mean gestational age was 28.8±1.8 weeks (nCPAP) versus 29±1.9 weeks (BiPAP). There were no statistically significant differences between groups in the failure of non-invasive respiratory support (25% vs. 33%, RR: 0.74, 95% CI: 0.47-1.17) or surfactant administration (35% vs. 38%, RR: 0.92, 95% CI: 0.49-1.71). No significant differences were observed in secondary outcomes between the two groups. Subgroup analysis of infants<30 weeks yielded similar results. Conclusion Although two-level CPAP theoretically offers benefits, BiPAP was not superior to nCPAP as initial support in preterm infants with RDS. This underscores the continued value of the simpler, well-established nCPAP and the need for multicentre trials involving preterm infants of varying gestational ages.