Synchronised Non-Invasive Intermittent Positive Pressure Ventilation in Very Preterm Infants After Birth: A Feasibility Study.

AIM: During perinatal transition, breathing effort in preterm infants is largely inefficient. In the current study, we assessed the feasibility of synchronised non-invasive positive pressure ventilation (S-NIPPV) in very preterm infants as primary respiratory support in the delivery room.

METHODS

Single-center prospective feasibility study at Tübingen University Hospital. Preterm infants with a gestational age (GA) between 26 and 32 weeks received S-NIPPV during the first 10 min after birth. Synchronisation was achieved using a Graseby capsule; spontaneous breaths were detected by respiratory inductance plethysmography (RIP). Primary outcome was synchronisation rate.

RESULTS

Ten preterm infants with a median GA of 28.8 weeks (IQR 27.6-30.4) and a birth weight of 1028 g (819-1213) were included. S-NIPPV was started within 44 (41-73) seconds after arrival on the resuscitaire. Synchrony rate was 68% (56-76) despite infants being handled significantly and 33% (27-40) of the time interventions were performed.

CONCLUSION

S-NIPPV as primary respiratory support after birth is feasible with reasonable synchrony, even though infants are frequently stimulated and handled. Future studies are needed to confirm the results of this small pilot study and to determine the effect of S-NIPPV on physiological and clinical outcomes.

TRIAL REGISTRATION: Feasibility and Reliability of Synchronized Non-invasive Intermittent Positive Pressure Ventilation in Preterm Infants After Birth (SenSyNoPP); www.

CLINICALTRIALS: gov: NCT05399914.