Application of nasal continuous positive airway pressure in very low birth weight infants with respiratory distress

Objective To evaluate the therapeutic effect of nasal continuous positive airway pressure (nCPAP) in very low birth weight infants( VLBWI) with respiratory distress. Methods One hundred and fifty-five VLBWI with respiratory distress needed mechanical ventilatory support were admitted to our NICU during 1999,1～2008,12. These infants were divided into two groups according to the admitted time. First group (admitted between 1999,1～2003,12) was treated with intermittent positive pressure ventilation (IPPV) only.Second group (admitted between 2004,1～2008,12) was treated with nCPAP only or IPPV + nCPAP or IPPV.The complications, survival rate and the average duration of IPPV of the two groups were compared. Results Fifty-three VLBWI were in the first group. The mean duration of IPPV was (6. 16 ±4. 84) d. One hundred and two VLBWI were in the second group, of which 60 patients received ventilation with nCPAP only,20 patients with IPPV + nCPAP.and 22 patients with IPPV. The mean duration of IPPV was (3. 93 ±2.48) d.Although the IPPV duration was decreased in the second group, but there was no statistically significant difference (f = 1. 37, P ＞ 0. 05). The ventilator-associated pneumonia rate of the second group was decreased (x~2 = 6.08, P ＜ 0.01), and the survival rate of the second group was increased compared with that of the first goup (x~2 = 18.25, P ＜ 0.01). Conclusion nCPAP is an effective and safe method for treating very low birth weight infants with respiratory distress. It can reduce the use of IPPV and decrease the rate of ventilatorassociated pneumonia. Key words: Respiratory failure; Very low birth weight infant; Nasal continuous positive airway pressure;  Mechanical ventilation