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Critical Care Research and Practice
Volume 2012 (2012), Article ID 301818, 7 pages
Clinical Study

Flow-Synchronized Nasal Intermittent Positive Pressure Ventilation for Infants <32 Weeks' Gestation with Respiratory Distress Syndrome

1Neonatal Intensive Care Unit, Pediatric and Neonatal Department, “S.Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina, Via Ponte Quattro Capi, 39-00186 Rome, Italy
2Pediatric Emergency and Intensive Care, Department of Pediatrics, Policlinico “Umberto I,” Sapienza University of Rome, Viale Regina Elena, 324-00161, Rome, Italy
3SeSMIT-A.Fa.R., Medical Statistics & Information Technology, Fatebenefratelli Association for Biomedical and Sanitary Research, Lungotevere de’ Cenci, 5-00186 Rome, Italy
4L'altrastatistica srl Consultancy & Training, Biostatistics Office, Via Ermino, 16-00174 Rome, Italy

Received 31 August 2012; Accepted 1 November 2012

Academic Editor: Gustavo Rocha

Copyright © 2012 C. Gizzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aim. To evaluate whether synchronized-NIPPV (SNIPPV) used after the INSURE procedure can reduce mechanical ventilation (MV) need in preterm infants with RDS more effectively than NCPAP and to compare the clinical course and the incidence of short-term outcomes of infants managed with SNIPPV or NCPAP. Methods. Chart data of inborn infants <32 weeks undergoing INSURE approach in the period January 2009–December 2010 were reviewed. After INSURE, newborns born January –December 2009 received NCPAP, whereas those born January–December 2010 received SNIPPV. INSURE failure was defined as FiO2 need >0.4, respiratory acidosis, or intractable apnoea that occurred within 72 hours of surfactant administration. Results. Eleven out of 31 (35.5%) infants in the NCPAP group and 2 out of 33 (6.1%) infants in the SNIPPV group failed the INSURE approach and underwent MV ( ). Fewer infants in the INSURE/SNIPPV group needed a second dose of surfactant, a high caffeine maintenance dose, and pharmacological treatment for PDA. Differences in O2 dependency at 28 days and 36 weeks of postmenstrual age were at the limit of significance in favor of SNIPPV treated infants. Conclusions. SNIPPV use after INSURE technique in our NICU reduced MV need and favorably affected short-term morbidities of our premature infants.