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Nasal intermittent positive pressure ventilation (NIPPV) during neonatal endotracheal intubation: A randomized controlled trial
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  • Ozkan Ilhan,
  • Kiymet Celik,
  • Nurten Zarif Ozkan,
  • İpek Kocaoglu,
  • Sema Arayici,
  • Nilay Hakan
Ozkan Ilhan
Mugla Sitki Kocman Universitesi Tip Fakultesi

Corresponding Author:[email protected]

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Kiymet Celik
Akdeniz Universitesi Tip Fakultesi
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Nurten Zarif Ozkan
Akdeniz Universitesi Tip Fakultesi
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İpek Kocaoglu
Mugla Sitki Kocman Universitesi Tip Fakultesi
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Sema Arayici
Akdeniz Universitesi Tip Fakultesi
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Nilay Hakan
Mugla Sitki Kocman Universitesi Tip Fakultesi
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Abstract

Background: The present study aimed to determine whether the use of nasal intermittent positive pressure ventilation (NIPPV) during neonatal endotracheal intubation increases the rate of successful intubation without physiological instability during all intubation attempts. Material and Methods: The present study was designed as a prospective, multicenter, randomized, controlled study conducted with neonates undergoing endotracheal intubation. The infants were assigned randomly to either the NIPPV group or the standard care group. The primary outcome was successful intubation without physiological instability (defined as ≥20% decline in the peripheral oxygen saturation [SpO 2] from pre-intubation value or bradycardia with a heart rate of <100 beats per minute) during all intubation attempts. Results: A total of 150 infants were enrolled (75 for the NIPPV group and 75 for the standart-care group). The infants had a mean postmenstrual age of 32.5 weeks and a median weight of 1552 g at the time of intubation. The incidence of successful intubation without physiological instability during all intubation attempts was significantly higher in the NIPPV group (64%) compared to the standard-care group (42.7%) (p = 0.009). This difference was particularly significant when inexperienced practitioners were involved. In the NIPPV group, the rate of bradycardia and severe desaturation was significantly lower, while the lowest SpO 2 level and the lowest heart rate level were significanlty higher. Conclusion: NIPPV during endotracheal intubation increases the incidence of successful intubation without physiological instability during all intubation attempts in neonates, while reducing the rate of hypoxia and bradycardia.
11 Sep 2024Submitted to Pediatric Pulmonology
12 Sep 2024Submission Checks Completed
12 Sep 2024Assigned to Editor
12 Sep 2024Review(s) Completed, Editorial Evaluation Pending
19 Oct 2024Reviewer(s) Assigned