Neonatal Noninvasive Ventilation Techniques: Do We Really Need to Intubate?

Author: DiBlasi, Robert M

Source: Respiratory Care, Volume 56, Number 9, September 2011 , pp. 1273-1297(25)

Publisher: The Journal Respiratory Care Company

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Abstract:

The current trend for supporting neonates with respiratory distress syndrome is nasal continuous positive airway pressure (CPAP). Nearly half of all neonates who are supported with CPAP will still develop respiratory failure that requires potentially injurious endotracheal intubation and invasive ventilation. Thus, the role of any neonatal clinician is to minimize invasive ventilation whenever possible, to avoid the multitude of complications that can arise when using this form of therapy. Noninvasive ventilation (NIV) is a form of respiratory assistance that provides greater respiratory support than does CPAP and may prevent intubation in a larger fraction of neonates who would otherwise fail CPAP. With the inception of nasal airway interfaces, clinicians have ushered in many different forms of NIV in neonates, often with very little experimental data to guide management. This review will explore in detail all of the different forms of neonatal NIV that are currently focused within an area of intense clinical investigation.

Keywords: infant mechanical ventilation; nasal continuous positive airway pressure; nasal ventilation; neonatal intensive care; noninvasive intermittent positive pressure ventilation

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.01376

Affiliations: Center for Developmental Therapeutics, Seattle Children’s Research Institute, Seattle, Washington, USA

Publication date: September 1, 2011

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