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Nasal mask versus nasal prongs for delivering nasal continuous positive airway pressure in preterm infants with respiratory distress: A randomized controlled trial

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Abstract

Objective

To compare the effectiveness of nasal continuous positive airway pressure delivered by Nasal mask vs Nasal prongs with respect to continuous positive airway pressure failure.

Study design

Randomized, controlled, open label, trial.

Setting

Tertiary care level III neonatal unit.

Participants

118 preterm infants-gestational age (27-34 weeks) requiring nasal continuous positive airway pressure as a primary mode for respiratory distress, who were treated with either nasal mask (n=61) or nasal prongs (n=57) as interface.

Primary outcome

Need for mechanical ventilation within 72 h of initiating support.

Results

Nasal continuous positive airway pressure failure occurred in 8 (13%) of Mask group and 14 (25%) of Prongs group but was statistically not significant (RR 0.53, 95% CI 0.24-1.17) (P = 0.15). The rate of pulmonary interstitial emphysema was significantly less in the Mask group (4.9% vs. 17.5%; RR 0.28, 95% CI 0.08-0.96; P = 0.03). Incidence of moderate nasal trauma (6.5% vs 21%) (P=0.03) and overall nasal trauma (36% vs 58%) (P=0.02) were significantly lower in mask group than in the prongs group.

Conclusion

Nasal continuous positive airway pressure with mask as interface is as effective as prongs but causes less nasal trauma and pulmonary interstitial emphysema.

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References

  1. Polin RA, Sahni R. Newer experience with CPAP. Semin Neonatol. 2002;7: 379–89

    Article  PubMed  Google Scholar 

  2. Pillow JJ, Hillman N, Moss TJ. Bubble continuous positive airway pressure enhances lung volume and gas exchange in preterm lambs. Am J Respir Crit Care Med. 2007;176:63–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tapia JL, Urzua S, Bancalari A. Randomized trial of early bubble continuous positive airway pressure for very low birth weight infants. J Pediatr. 2012;161:75–80

    Article  PubMed  Google Scholar 

  4. Bonner KM, Mainous RO. The nursing care of the infant receiving bubble CPAP therapy. Adv Neonatal Care. 2008;8:78–95.

    Article  PubMed  Google Scholar 

  5. McCoskey L. Nursing care guidelines for prevention of nasal breakdown in neonates receiving nasal CPAP. Adv Neonatal Care. 2008;8:116–24.

    Article  PubMed  Google Scholar 

  6. Kattwinkel J, Fleming D, Cha CC, Fanaroff AA, Klaus MH. A device for administration of continuous positive airway pressure by the nasal route. Pediatrics. 1973;52:131–4.

    PubMed  CAS  Google Scholar 

  7. Kieran EA, Walsh H, O’Donnell CPF. Survey of nasal continuous positive airways pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) use in Irish newborn nurseries. Arch Dis Child Fetal Neonatal Ed. 2011;96: F156.

    Article  PubMed  Google Scholar 

  8. Kieran EA, Twomey AR, Molloy EJ, Murphy JF, O’Donnell CP. Randomized trial of prongs or mask for nasal continuous positive airway pressure in preterm infants. Pediatrics. 2012;130:1170–6.

    Article  Google Scholar 

  9. Chandrasekaran A, Sachdeva A, Sankar MJ, Agarwal R, Deorari AK, Paul VK. Nasal mask versus nasal prongs in the delivery of continuous positive airway pressure in preterm infants–An open label randomized controlled trial. E-PAS. 2014:2936:512.

    Google Scholar 

  10. Fischer C, Bertelle V, Hohlfeld J, Forcada-Guex M, Stadelmann-Diaw C, Tolsa JF. Nasal trauma due to continuous positive airway pressure in neonates. Arch Dis Child Fetal Neonatal Ed. 2010;95:F447-51.

    Article  PubMed  Google Scholar 

  11. Yong SC, Chen SJ, Boo NY. Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants: a randomised control study. Arch Dis Child Fetal Neonatal Ed. 2005;90:480–83.

    Article  Google Scholar 

  12. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500gm. J Pediatr. 1978;92:529–33.

    Article  PubMed  CAS  Google Scholar 

  13. Kliegman RM, Walsh MC. Necrotizing enterocolitis: pathogenesis, classification and spectrum of illness. Curr Probl Pediatr. 1987;17:213–88.

    PubMed  CAS  Google Scholar 

  14. International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123:991–99.

    Article  Google Scholar 

  15. Bancalari E, Jobe AH. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163:1723–9.

    Article  PubMed  Google Scholar 

  16. Urs PS, Khan F, Maiya PP. Bubble CPAP-a primary respiratory support for respiratory distress syndrome in newborns. Indian Pediatr. 2009;46:409–11.

    PubMed  Google Scholar 

  17. Koti J, Murki S, Gaddam P, Reddy A, Reddy MD. Bubble CPAP for respiratory distress syndrome in preterm infants. Indian Pediatr. 2010;47:139–43.

    Article  PubMed  Google Scholar 

  18. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB; COIN Trial Investigators.Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008;358:700–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. From Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal and General Hospital, Mumbai, India

    Sorabh Goel, Jayashree Mondkar, Harshad Panchal, Deeparaj Hegde, Alpana Utture & Swati Manerkar

Authors
  1. Sorabh Goel
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  2. Jayashree Mondkar
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  3. Harshad Panchal
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  4. Deeparaj Hegde
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  5. Alpana Utture
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  6. Swati Manerkar
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Correspondence to Sorabh Goel.

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Goel, S., Mondkar, J., Panchal, H. et al. Nasal mask versus nasal prongs for delivering nasal continuous positive airway pressure in preterm infants with respiratory distress: A randomized controlled trial . Indian Pediatr 52, 1035–1040 (2015). https://doi.org/10.1007/s13312-015-0769-9

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  • DOI: https://doi.org/10.1007/s13312-015-0769-9

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