Nasal intermittent positive pressure ventilation in neonates with meconium aspiration syndrome
Abstract
Background: Nasal intermittent positive pressure ventilation ( NIPPV) as primary respiratory support in neonates with meconium aspiration syndrome (MAS) has not been studied. The present study applied the use of NIPPV as a treatment modality in MAS and tried to identify factors predicting NIPPV failure.
Objective: The aim was to identify failure rates of MAS on NIPPV and potential predictors of NIPPV failure.
Design: Observational analytical study.
Methods: 86 neonates were admitted during the study period of 2 years of which 60 were included and NIPPV was applied as the primary modality of respiratory support with available ventilators. Outcome variables were compared between the MAS infants who failed NIPPV and those who were successfully managed with NIPPV.
Results: 7 neonates (11.7%) out of 60 enrolled neonates failed on NIPPV. There was a significant decrease in Downe score, respiratory rate, heart rate, fio2 requirement after 6 hours compared to a baseline measurement (p<0.01). On univariate analysis factors associated with NIPPV failure were high Fio2, high PEEP, at one hour of starting NIPPV (p<0.05). However, on logistic regression none of the factors were predicting failure independently.
Conclusion: NIPPV applied early may reduce the need for mechanical ventilation in neonates with moderate to severe MAS.
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