Intermittent ventilation failed to benefit infants with respiratory distress syndrome

Meneses J. Pediatrics. 2011;127:300-307.

When compared with continuous positive airway pressure, intermittent positive-pressure ventilation did not appear to decrease the need for mechanical ventilation in infants with respiratory distress syndrome, according to research published online. More research is needed on this practice in neonates with larger birth weights, the researchers wrote.

Jucille Meneses, MD, and colleagues from Brazil, working with colleagues at Yale University School of Medicine, conducted a single-center trial between August 2007 and September 2009 at an inborn tertiary NICU. Enrolled infants had gestational ages of 26 to 33 weeks. The researchers randomly assigned 200 infants, 100 in each arm, to either group. Neonates’ need for mechanical ventilation within the first 72 hours of life did not differ significantly between the two groups, but in post-hoc analysis, significantly more infants in the intermittent group remained extubated compared with those in the continuous positive airway pressure group. (10% vs. 22%; RR=0.45; 95% CI, 0.22–0.91).

The researchers said the rate of failure was lower in the group of infants who had a birth weight of more than 1,000 g, which could indicate a particular avenue in reducing the need for ventilation in this subgroup of patients. However, this subgroup of neonates was small and their findings should be interpreted with caution, they wrote.

Disclosure: The researchers reported no relevant financial disclosures.