[Non-invasive mandatory ventilation in extremely low birth weight and very low birth weight newborns with failed respiration].

Early extubation of ELBW and VLBW premature infants treated with IMV results in decreased incidence of tracheal and laryngeal injury, lowers the risk of nosocomial infection, decreases the severity and frequency of bronchopulmonary dysplasia (BPD). Due to prematurity this group of patients is especially susceptible to extubation failure because of apnoe, hypoventilation and atelectasis. In clinical practice attempt was made to provide adequate noninvasive ventilation by the use of nasal intermittent mandatory ventilation in the case of apnoe of prematurity. Advantages of noninvasive nasal IMV oppose the risk of stomach distension and regurgitation due to high tension of pylorus combined with inadequate cardia tension. The aim of study was the evaluation of noninvasive nasal IMV effectiveness along with a risk of abdominal distension caused by air trapping. 32 patients were examined during one year of studies. In all but one the use of nasal intermittent mandatory ventilation resulted in decreased incidence of apnoe of prematurity. Satisfactory levels of SaO2 and pCO2 were achieved without endotracheal tube placement, avoiding the risks of nosocomial pneumonia and bronchopulmonary dysplasia.