Comparison of short-term outcomes between Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation in preterm neonates with respiratory distress syndrome.

Objective: To compare the safety and effectiveness of nasal continuous positive airway pressure (NCPAP) versus nasal intermittent positive pressure ventilation (NIPPV) as initial respiratory therapy among preterm neonates with respiratory distress syndrome (RDS). Study Design: Randomized Controlled Trial. Setting: The Neonatal Intensive Care Unit (NICU) of Indus Hospital and Health Network, Muzaffargarh, Pakistan. Period: January 2024 to June 2024. Methods: A total of 118 preterm neonates with 26-34 weeks gestation and admitted to NICU with RDS were randomly allocated to either NCPAP or NIPPV. Success respiratory support, along with complications, and mortality were noted. Results: In a total of 118 newborns, 64 (54.2%) were girls. The mean gestational age, and birth weight were 30.94±1.43 weeks, and 1479.07±310.69 grams. In NIPPV group, 49 (83.1%) babies showed successful outcome versus 29 (49.2%) in NCPAP group (p<0.001). Necessitation of intubation within 7 days (40.7% vs. 22.0%, p=0.029). Surfactant requirement (37.3% vs. 16.9%, p=0.013), and bronco pulmonary dysplasia (BDP) (11.9% vs. 0%, p=0.006) were significantly more in NCPAP group. Pneumothorax was significantly more prevalent in NIPPV group (18.6% vs. 3.4%, p=0.008). Duration of non-invasive support was significantly more in NCPAP group (10.58±6.07 vs. 8.15±3.58 days, p=0.009). Conclusion: NIPPV significantly outperformed NCPAP in terms of successful outcomes, as measured by reduced rates of intubation, surfactant requirement, and the incidence of BPD.