Respiratory Distress Syndrome In Premature Infants Clinical Trial
Official title:
Successful Extubation and Noninvasive Ventilation in Preterm Infants ≤ 1500g Terms
Noninvasive ventilation has been used in preterm newborn with respiratory distress syndrome in an attempt to assist failure extubation. The investigators investigated failure extubation in infants gestational age less than or equal to 34 weeks and weights less than or equal to 1500 grams. Neonates were randomized to noninvasive modalities support. 101 newborns were included in this study in three groups , group 1: Nasal Intermittent Positive Pressure Ventilation (NIPPV) (n=36), group 2: Nasal Continuous Positive Airway Pressure Bubble (NCPAP bubble) (n=33) and group 3: Nasal Continuous Positive Airway Pressure Bubble Ventilator (NCPAP ventilator) (n=32)
The infants were randomly allocated after extubation used a list of computer-generated
randomization in NIPPV modes (with the following settings: positive inspiratory pressure
(PIP) < 16 centimeters of water (cm H2O), positive end-expiratory pressure (PEEP) 4-5
centimeters of water (cm H2O, backup respiratory rate (RR) < 18 cycles per minute flow 6-7
liters per minute (L / min) and inspiratory time (TI) according to the time constant for
idae (0.30 to 0.34 seconds), and respirator seal to NCPAP water tower was adjusted to 4-5
centimeters of water (cm H2O) PEEP, flow 6-7 liters per minute (L / Min.) oxygen for both
was adjusted to maintain arterial oxygen saturation between 85-95%
The criteria for extubation were defined using a protocol by the clinic staff, confirmed by
arterial blood gases and chest X-ray, as well as adjustments of the ventilator settings.
Vital signs, blood gas parameters and noninvasive brackets were recorded before,
immediately, 15, 30, 45 minutes, 1(hour) h, 2h, 12h, 24h and 48 h after extubation were
documented.
Neonatal morbidities were documented until discharge, among these are: patent ductus
arterious, necrotizing enterocolitis, retinopathy of prematurity, intracranial hemorrhage
and pneumothorax.
Data on achievement of prenatal, antenatal steroids and surfactant administration were
documented. All newborns were natural porcine surfactant Curosurf®.
The total duration of mechanical ventilation and oxygen were documented from birth until
discharge or death. The supplemental oxygen or mechanical ventilation days was defined as
daily requirement of fraction of inspired oxygen (FiO 2)> 0.21 or ventilation > 12 hours,
respectively.
The newborns were followed for all interaction until discharge (about 5 weeks).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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