Verwer, J. (Jori) (2013) Ademhalingsondersteuning bij prematuren; effectiviteit vs. complicaties. thesis, Medicine.
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Abstract
Background: Continuous positive airway pressure (CPAP) and nasal intermittent positive pressure ventilation (NIPPV) are two ways of noninvasive breathing support. Both give a continuous pressure, but NIPPV also supports every breath. Therefore NIPPV may be a better support, but may also cause more complications, because NIPPV blows more air into the lungs and stomach. It is important to determine the balance between effectiveness and complications between NIPPV and CPAP in preterm born infants in the NICU of a single participating center. Objective: In anticipation the results of an international trial, we aimed to investigate the differences between effectiveness and complications between the use of NIPPV and CPAP as a treatment method for preterm born infants in a single medical center. We formulated death or BPD as the primary outcome, and we formulated several secondary outcomes, such as the duration of breathing support (effectiveness) and gastrointestinal problems (complications). Methods: We included preterm born infants <30 wk GA and <1000gram at birth, hospitalized at the NICU at the UMCG. They were treated with either NIPPV or CPAP, their treatment was decided by randomization. We compared both groups by comparing their differences between their effectiveness and complications. Results: 32 infants were included, 17 randomised to NIPPV and 15 to CPAP. Median gestational age (GA) of the NIPPV-group was 271 weeks (250-291) birth weight 840 grams (570-1000), median GA of the CPAP-group was 280 weeks (25-296) birth weight 900 grams (600-995). 29% of the infants in the NIPPV-group either died, developed BPD or both, against 47% of the CPAP-group (p=0.47). No differences were found in other respiratory outcomes, such as number of reintubations (7(42%) versus 6(40%) p=1.0) and duration of respiratory support (53 versus 40 days (p=0.407)). Gastrointestinal complications such as occurrence of NEC (4 (24%) versus 4 (27%) p=1.0) and growth (151 versus 152 g/wk (p=0.845) also showed no differences. Conclusions: No differences were found in effectiveness and complications when NIPPV is compared to CPAP. In anticipation of the results of the international trial, we found no differences in this small group of infants in a single participating center.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bos, Prof. Dr. A.F. and Dijk, Dr. P.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2337 |
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