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Minerva Pediatrica 2020 Jul 07
DOI: 10.23736/S0026-4946.20.05677-7
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
Positive pressure ventilation in the weaning of preterm newborns
Paulo MAGALHÃES 1 ✉, Pedro L. SILVA 2, Larissa ALMEIDA 3, Maria do Carmo LIMA 3, Ivana F. SANTOS 3, Carlos A. CAMILLO 4, 5, Aline SENA 3
1 Baby GrUPE, University of Pernambuco, Pernambuco, Brazil; 2 Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 3 Health Institute Elpídio de Almeida, Paraíba, Brazil; 4 State University of Londrina, Paraná, Brazil; 5 University Pitágoras Unopar, Paraná, Brazil
BACKGROUND: Weaning from invasive mechanical ventilation (IMV) of preterm newborns (PTNB) is one of the critical stages of life support in the neonatal intensive care unit (NICU). Noninvasive positive pressure ventilation (NPPV) has been used to facilitate weaning from IMV and includes continuous positive airway pressure (CPAP) without or with inspiratory pressure support (Bilevel NPPV). Nevertheless, there is little information about their adherence and success rate during weaning process.
METHODS: In this retrospective cohort study, weaning data from patients admitted to a NICU from the northeast region of Brazil were analyzed. Sample was composed of PTNB submitted to IMV and divided in two groups according to the weaning strategy adopted: Bilevel NPPVor NCPAP. Weaning failure was defined as returning to IMV within less than 48h after extubation.
RESULTS: Fifty-seven PTNB were included. Majority were female, had caesarean delivery, very low weight upon birth (760-1,480g) and neonatal hypoxemia scores (Apgar) <7 in the first minute. Respiratory distress syndrome occurred in 56.7% of PTNB whilst respiratory infections occurred in 35.1% of patients. Bilevel NPPV was the most chosen modality of weaning. No difference in success rate was found between Bilevel NPPV and NCPAP (p=0.17).
CONCLUSIONS: In this study, the application of noninvasive ventilation in preterm newborns for weaning from IMV was similar success rate between Bilevel NPPV and NCPAP.
KEY WORDS: Mechanical ventilation; Ventilator weaning, neonatology