Comparison Of Effectiveness Of Two Non-invasive Modes Of Ventilation In The Treatment Of Neonatal Respiratory Distress Syndrome

Objective:To compare the effectiveness of nasal intermittent positive pressure ventilation（NIPPV）and nasal continuous positive airway pressure（NCPAP）in the treatment of neonatal respiratory distress syndrome（NRDS）.Methods:A total of 240 preterm infants diagnosed with neonatal respiratory distress syndrome who were admitted to the Department of Neonatology and Neonatal Intensive Care Unit（NICU）of Shanxi Children’s Hospital from January 2020 to December 2021,with gestational age of 30～36⁺⁶weeks and birth age≤24 hours,were included in this study by retrospective analysis.According to the non-invasive respiratory support model,they were divided into NIPPV group（n=79）and NCPAP group（n=161）.Except for respiratory support,other treatments were the same between the two groups.Changes in arterial blood gas values such as p H,oxygen partial pressure（PO₂）,carbon dioxide partial pressure（PCO₂）and oxygen saturation（SO₂）within 12 hours after using the noninvasive ventilator,noninvasive failure reintubation rate,hospital stay,and related complications include the incidence of pneumothorax,neonatal necrotizing enterocolitis（NEC）,bronchopulmonary dysplasia（BPD）,Patent ductus arteriosus,intracranial hemorrhage,apnea,and retinopathy of prematurity（ROP）were compared between the two groups.Results:There was no significant difference in p H,PO₂,PCO₂and SO₂between the two groups before using the noninvasive ventilator.Within 12 hours after using the noninvasive ventilator,PO₂and SO₂in NIPPV group were higher than those in NCPAP group（P﹤0.05）,PCO₂was lower than NCPAP group（P﹤0.05）,there was no significant difference in p H between the two groups.The reintubation rate and hospital stay in NIPPV group were lower than those in NCPAP group（P﹤0.05）.Compared with the two groups,0 cases of BPD,apnea and ROP were found in NIPPV group,while 4 cases of BPD,2 cases of apnea and 9 cases of ROP were found in NCPAP group.There was no statistical difference in the incidence of pneumothorax,NEC,patent ductus arteriosus and intracranial hemorrhage between the two groups（P>0.05）.Conclusion:Both NIPPV and NCPAP can effectively improve respiratory distress symptoms in children,but compared with NCPAP,NIPPV can effectively increase PO₂,reduce PCO₂,improve oxygenation,reduce reintubation rate,reduce the need for invasive ventilation,shorten hospital stay and not increase the incidence of related complications（such as pneumothorax,NEC,patent ductus arteriosus and intracranial hemorrhage）.