The Effect of Ventilatory Supports on Oxidative Stress Biomarkers in Preterm Respiratory Distress

Background: Respiratory distress syndrome (RDS) is the most common respiratory condition in preterm infants, requiring ventilatory support. The challenge lies in optimizing respiratory care while minimizing oxidative stress (OS), with various non-invasive ventilation (NIV) options now available.Aim of the Work: To compare, humidified high-flow nasal cannula (HHFNC) vs nasal intermittent positive pressure ventilation (NIPPV), in preterm with RDS, by evaluating their effects on OS: serum malondialdehyde (MDA) and total antioxidant capacity (TAC).Patients and methods: Forty infants (≤35 weeks’ gestation) required NIV on first day of life for RDS randomly divided into two groups; HHFNC or NIPPV (n=20 each). MDA and TAC were measured at start of NIV and after 24hours.Results: After 24hours, HHFNC exhibited significantly diminished levels of MDA and TAC than NIPPV (P=0.037 and 0.000, respectively). Non-survivors in HHFNC group recorded significantly higher MDA and TAC levels than survivors (P < 0.001). In the NIPPV group, TAC levels were notably higher in patients with BPD versus those without (P = 0.003), as well as in those who died compared to those who survived (P < 0.001). MDA and TAC levels demonstrated significant positive correlation with length of stay in both groups. Although mortality rate in HHFNC was lower (15%) compared to NIPPV (25%), variation observed was not statistically significant.Conclusions: HHFNC may offer benefits by reducing OS compared to NIPP