Invasive and non-invasive ventilation for prematurely born infants - current practice in neonatal ventilation

Anne Greenough, Ingran Lingam

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)

    Abstract

    Non-invasive techniques, include nasal continuous positive airways pressure (nCPAP), nasal intermittent positive pressure ventilation (NIPPV) and heated, humidified, high flow cannula (HHFNC). Randomised controlled trials (RCTs) of nCPAP versus ventilation have given mixed results, but one demonstrated fewer respiratory problems during infancy. Meta-analysis demonstrated NIPPV rather than nCPAP provided better support post extubation. After extubation or initial support HHFNC has similar efficacy to CPAP. Invasive techniques include those that synchronise inflations with the patient's respiratory efforts. Assist control/ synchronised intermittent mandatory ventilation compared to non triggered modes only reduce the duration of ventilation. Further data are required to determine the efficacy of proportional assist ventilation and neurally adjusted ventilatory assist. Other techniques aim to minimise volutrauma. RCTs of volume targeted ventilation demonstrated reductions in BPD and respiratory medication usage at follow-up. Prophylactic high frequency oscillatory ventilation does not reduce BPD, but is associated with superior lung function at school age.

    Original languageEnglish
    Pages (from-to)185-92
    Number of pages8
    JournalExpert review of respiratory medicine
    Volume10
    Issue number2
    Early online date28 Jan 2016
    DOIs
    Publication statusE-pub ahead of print - 28 Jan 2016

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