Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial
Background Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effe...
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| Veröffentlicht in: | Archives of disease in childhood. Fetal and neonatal edition 2015-01, Vol.100 (1), p.F17-F23 |
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| container_title | Archives of disease in childhood. Fetal and neonatal edition |
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| creator | Gizzi, Camilla Montecchia, Francesco Panetta, Valentina Castellano, Chiara Mariani, Chiara Campelli, Maristella Papoff, Paola Moretti, Corrado Agostino, Rocco |
| description | Background Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effective. Objective To assess the effects of flow-SNIPPV, NIPPV and NCPAP on the rate of desaturations and bradycardias in preterm infants and, secondarily, to evaluate their influence on pattern of breathing and gas exchange. Patients and methods Nineteen infants (mean gestational age at study 30 weeks, 9 boys) with apnoeic spells were enrolled in a randomised controlled trial with a cross-over design. They received flow-SNIPPV, NIPPV and NCPAP for 4 h each. All modes were provided by a nasal conventional ventilator able to provide synchronisation by a pneumotachograph. The primary outcome was the event rate of desaturations (≤80% arterial oxygen saturation) and bradycardias (≤80 bpm) per hour, obtained from cardiorespiratory recordings. The incidence of central apnoeas (≥10 s) as well as baseline heart rate, FiO2, SpO2, transcutaneous blood gases and respiratory rate were also evaluated. Results The median event rate per hour during flow-SNIPPV, NIPPV and NCPAP was 2.9, 6.1 and 5.9, respectively (p |
| doi_str_mv | 10.1136/archdischild-2013-305892 |
| format | Article |
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A randomised cross-over trial</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Gizzi, Camilla ; Montecchia, Francesco ; Panetta, Valentina ; Castellano, Chiara ; Mariani, Chiara ; Campelli, Maristella ; Papoff, Paola ; Moretti, Corrado ; Agostino, Rocco</creator><creatorcontrib>Gizzi, Camilla ; Montecchia, Francesco ; Panetta, Valentina ; Castellano, Chiara ; Mariani, Chiara ; Campelli, Maristella ; Papoff, Paola ; Moretti, Corrado ; Agostino, Rocco</creatorcontrib><description>Background Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effective. Objective To assess the effects of flow-SNIPPV, NIPPV and NCPAP on the rate of desaturations and bradycardias in preterm infants and, secondarily, to evaluate their influence on pattern of breathing and gas exchange. Patients and methods Nineteen infants (mean gestational age at study 30 weeks, 9 boys) with apnoeic spells were enrolled in a randomised controlled trial with a cross-over design. They received flow-SNIPPV, NIPPV and NCPAP for 4 h each. All modes were provided by a nasal conventional ventilator able to provide synchronisation by a pneumotachograph. The primary outcome was the event rate of desaturations (≤80% arterial oxygen saturation) and bradycardias (≤80 bpm) per hour, obtained from cardiorespiratory recordings. The incidence of central apnoeas (≥10 s) as well as baseline heart rate, FiO2, SpO2, transcutaneous blood gases and respiratory rate were also evaluated. Results The median event rate per hour during flow-SNIPPV, NIPPV and NCPAP was 2.9, 6.1 and 5.9, respectively (p<0.001 and 0.009, compared with flow-SNIPPV). Central apnoeas per hour were 2.4, 6.3 and 5.4, respectively (p=0.001, for both compared with flow-SNIPPV), while no differences in any other parameter studied were recorded. Conclusions Flow-SNIPPV seems more effective than NIPPV and NCPAP in reducing the incidence of desaturations, bradycardias and central apnoea episodes in preterm infants.</description><identifier>ISSN: 1359-2998</identifier><identifier>EISSN: 1468-2052</identifier><identifier>DOI: 10.1136/archdischild-2013-305892</identifier><identifier>PMID: 25318667</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Apnea - therapy ; Babies ; Bradycardia - prevention & control ; Cross-Over Studies ; Female ; Fourier transforms ; Gas exchange ; Heart rate ; Humans ; Infant, Premature ; Infant, Premature, Diseases - therapy ; Infants ; Intermittent Positive-Pressure Ventilation - methods ; Male ; Noninvasive Ventilation - methods ; Positive-Pressure Respiration - methods ; Premature birth ; Respiratory Distress Syndrome, Newborn ; Respiratory therapy ; Sensors ; Software ; Ventilation ; Ventilators</subject><ispartof>Archives of disease in childhood. Fetal and neonatal edition, 2015-01, Vol.100 (1), p.F17-F23</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b470t-6a8c27fbff005a54512b286e9828429b8a74b65c4ce6474cf682b3af210f42bc3</citedby><cites>FETCH-LOGICAL-b470t-6a8c27fbff005a54512b286e9828429b8a74b65c4ce6474cf682b3af210f42bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://fn.bmj.com/content/100/1/F17.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://fn.bmj.com/content/100/1/F17.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77342,77373</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25318667$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gizzi, Camilla</creatorcontrib><creatorcontrib>Montecchia, Francesco</creatorcontrib><creatorcontrib>Panetta, Valentina</creatorcontrib><creatorcontrib>Castellano, Chiara</creatorcontrib><creatorcontrib>Mariani, Chiara</creatorcontrib><creatorcontrib>Campelli, Maristella</creatorcontrib><creatorcontrib>Papoff, Paola</creatorcontrib><creatorcontrib>Moretti, Corrado</creatorcontrib><creatorcontrib>Agostino, Rocco</creatorcontrib><title>Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial</title><title>Archives of disease in childhood. Fetal and neonatal edition</title><addtitle>Arch Dis Child Fetal Neonatal Ed</addtitle><description>Background Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effective. Objective To assess the effects of flow-SNIPPV, NIPPV and NCPAP on the rate of desaturations and bradycardias in preterm infants and, secondarily, to evaluate their influence on pattern of breathing and gas exchange. Patients and methods Nineteen infants (mean gestational age at study 30 weeks, 9 boys) with apnoeic spells were enrolled in a randomised controlled trial with a cross-over design. They received flow-SNIPPV, NIPPV and NCPAP for 4 h each. All modes were provided by a nasal conventional ventilator able to provide synchronisation by a pneumotachograph. The primary outcome was the event rate of desaturations (≤80% arterial oxygen saturation) and bradycardias (≤80 bpm) per hour, obtained from cardiorespiratory recordings. The incidence of central apnoeas (≥10 s) as well as baseline heart rate, FiO2, SpO2, transcutaneous blood gases and respiratory rate were also evaluated. Results The median event rate per hour during flow-SNIPPV, NIPPV and NCPAP was 2.9, 6.1 and 5.9, respectively (p<0.001 and 0.009, compared with flow-SNIPPV). Central apnoeas per hour were 2.4, 6.3 and 5.4, respectively (p=0.001, for both compared with flow-SNIPPV), while no differences in any other parameter studied were recorded. Conclusions Flow-SNIPPV seems more effective than NIPPV and NCPAP in reducing the incidence of desaturations, bradycardias and central apnoea episodes in preterm infants.</description><subject>Abdomen</subject><subject>Apnea - therapy</subject><subject>Babies</subject><subject>Bradycardia - prevention & control</subject><subject>Cross-Over Studies</subject><subject>Female</subject><subject>Fourier transforms</subject><subject>Gas exchange</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - therapy</subject><subject>Infants</subject><subject>Intermittent Positive-Pressure Ventilation - methods</subject><subject>Male</subject><subject>Noninvasive Ventilation - methods</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Premature birth</subject><subject>Respiratory Distress Syndrome, Newborn</subject><subject>Respiratory therapy</subject><subject>Sensors</subject><subject>Software</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>1359-2998</issn><issn>1468-2052</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkUtvEzEUhS1ERR_wF5AlNmUx1K-xPSsURW2JVNFZAFvLdmziaMYO9kyl7PjpdZuAEBtYXev6O-feqwMAxOgDxpRf6Ww361DsJgzrhiBMG4pa2ZEX4AwzLmurJS_rm7ZdQ7pOnoLzUrYIISyEeAVOSUux5FycgZ-rAss-2k1OMRS3hp9Xff8Njik76Lx3dgoPDk4bHY8_OlZm2S96GCKcstNTiN-h3sXkNEwe7rIb9TTnMO3h5eK-f_8RLmCuqjQ--9ucSmnSg8tVHfTwGpx4PRT35lgvwNeb6y_LT83d_e1qubhrDBNoariWlghvvEeo1S1rMTFEctdJIhnpjNSCGd5aZh1nglnPJTFUe4KRZ8RYegEuD767nH7Mrkyq7mPdMOjo0lwUlkhyRqmk_0Y5Fa3AVHQVffcXuk1zjvUQhYVEdc0Oo0rJA_V8fHZe7XIYdd4rjNRToOrPQNVToOoQaJW-PQ6YzejWv4W_EqwAPQBm3P6_7SPiza6p</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Gizzi, Camilla</creator><creator>Montecchia, Francesco</creator><creator>Panetta, Valentina</creator><creator>Castellano, Chiara</creator><creator>Mariani, Chiara</creator><creator>Campelli, Maristella</creator><creator>Papoff, Paola</creator><creator>Moretti, Corrado</creator><creator>Agostino, Rocco</creator><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20150101</creationdate><title>Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial</title><author>Gizzi, Camilla ; Montecchia, Francesco ; Panetta, Valentina ; Castellano, Chiara ; Mariani, Chiara ; Campelli, Maristella ; Papoff, Paola ; Moretti, Corrado ; Agostino, Rocco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b470t-6a8c27fbff005a54512b286e9828429b8a74b65c4ce6474cf682b3af210f42bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdomen</topic><topic>Apnea - therapy</topic><topic>Babies</topic><topic>Bradycardia - prevention & control</topic><topic>Cross-Over Studies</topic><topic>Female</topic><topic>Fourier transforms</topic><topic>Gas exchange</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - therapy</topic><topic>Infants</topic><topic>Intermittent Positive-Pressure Ventilation - methods</topic><topic>Male</topic><topic>Noninvasive Ventilation - methods</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Premature birth</topic><topic>Respiratory Distress Syndrome, Newborn</topic><topic>Respiratory therapy</topic><topic>Sensors</topic><topic>Software</topic><topic>Ventilation</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gizzi, Camilla</creatorcontrib><creatorcontrib>Montecchia, Francesco</creatorcontrib><creatorcontrib>Panetta, Valentina</creatorcontrib><creatorcontrib>Castellano, Chiara</creatorcontrib><creatorcontrib>Mariani, Chiara</creatorcontrib><creatorcontrib>Campelli, Maristella</creatorcontrib><creatorcontrib>Papoff, Paola</creatorcontrib><creatorcontrib>Moretti, Corrado</creatorcontrib><creatorcontrib>Agostino, Rocco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Archives of disease in childhood. Fetal and neonatal edition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gizzi, Camilla</au><au>Montecchia, Francesco</au><au>Panetta, Valentina</au><au>Castellano, Chiara</au><au>Mariani, Chiara</au><au>Campelli, Maristella</au><au>Papoff, Paola</au><au>Moretti, Corrado</au><au>Agostino, Rocco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial</atitle><jtitle>Archives of disease in childhood. Fetal and neonatal edition</jtitle><addtitle>Arch Dis Child Fetal Neonatal Ed</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>100</volume><issue>1</issue><spage>F17</spage><epage>F23</epage><pages>F17-F23</pages><issn>1359-2998</issn><eissn>1468-2052</eissn><abstract>Background Apnoea, desaturations and bradycardias are common problems in preterm infants which can be treated with nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV). It is unclear whether synchronised NIPPV (SNIPPV) would be even more effective. Objective To assess the effects of flow-SNIPPV, NIPPV and NCPAP on the rate of desaturations and bradycardias in preterm infants and, secondarily, to evaluate their influence on pattern of breathing and gas exchange. Patients and methods Nineteen infants (mean gestational age at study 30 weeks, 9 boys) with apnoeic spells were enrolled in a randomised controlled trial with a cross-over design. They received flow-SNIPPV, NIPPV and NCPAP for 4 h each. All modes were provided by a nasal conventional ventilator able to provide synchronisation by a pneumotachograph. The primary outcome was the event rate of desaturations (≤80% arterial oxygen saturation) and bradycardias (≤80 bpm) per hour, obtained from cardiorespiratory recordings. The incidence of central apnoeas (≥10 s) as well as baseline heart rate, FiO2, SpO2, transcutaneous blood gases and respiratory rate were also evaluated. Results The median event rate per hour during flow-SNIPPV, NIPPV and NCPAP was 2.9, 6.1 and 5.9, respectively (p<0.001 and 0.009, compared with flow-SNIPPV). Central apnoeas per hour were 2.4, 6.3 and 5.4, respectively (p=0.001, for both compared with flow-SNIPPV), while no differences in any other parameter studied were recorded. Conclusions Flow-SNIPPV seems more effective than NIPPV and NCPAP in reducing the incidence of desaturations, bradycardias and central apnoea episodes in preterm infants.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25318667</pmid><doi>10.1136/archdischild-2013-305892</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Archives of disease in childhood. Fetal and neonatal edition, 2015-01, Vol.100 (1), p.F17-F23 |
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| subjects | Abdomen Apnea - therapy Babies Bradycardia - prevention & control Cross-Over Studies Female Fourier transforms Gas exchange Heart rate Humans Infant, Premature Infant, Premature, Diseases - therapy Infants Intermittent Positive-Pressure Ventilation - methods Male Noninvasive Ventilation - methods Positive-Pressure Respiration - methods Premature birth Respiratory Distress Syndrome, Newborn Respiratory therapy Sensors Software Ventilation Ventilators |
| title | Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnoea of prematurity (AOP)? A randomised cross-over trial |
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