Comparative efficacy of non-invasive ventilation methods in managing neonatal pneumonia: a clinical outcome study

Purpose: The aim of this study was was to compare the effectiveness and outcomes of non-invasive ventilation (NIV) methods in neonates diagnosed with lower respiratory tract infections (LRTI). Materials and Methods: A prospective study was conducted in neonates with LRTI treated with high-flow nasal cannula (HFNC), nasal continuous positive airway pressure (NCPAP), or nasal intermittent positive pressure ventilation (NIPPV) in the neonatal intensive care unit. Method failure was defined as switching to another NIV method within 6 hours based on clinical and laboratory findings. The groups were compared for clinical and laboratory findings, length of hospital stay, outcomes, success rates, and complications. Results: One hundred and six neonates were included with a median gestational age of 38 weeks and birth weight of 2991±673 g. Downes scores at admission were significantly higher in the NCPAP group than in the others. The HFNC group had better of blood pH and CO2 levels but had a higher rate of treatment failure. NCPAP was associated with the highest success rate (86.8%), followed by NIPPV (78.7%) and HFNC (52.4%). The length of hospital stay was shorter in patients successfully treated with NCPAP and NIPPV. According to the logistic regression analysis, NIPPV significantly reduced the risk of failure compared to HFNC. Conclusion: NIPPV and NCPAP were more effective than HFNC in the management of neonatal LRTI with shorter hospital stay. HFNC may be effective in stabilizing baseline respiratory parameters in the management of neonatal LRTI.