Cochrane Summaries

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Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation

Davis PG, Lemyre B, De Paoli AG
Published Online: 
15 April 2009

There is some evidence that nasal intermittent positive pressure ventilation (NIPPV) increases the effectiveness of nasal continuous positive airway pressure (NCPAP) in preterm babies who no longer need an endotracheal tube (tube in the wind pipe). Preterm babies with breathing problems often require help from a machine (ventilator) that provides regular breaths through a tube in the windpipe. The process of extubation or removal of this tube does not always go smoothly and the tube may need to go back if the baby cannot manage by him/herself. NCPAP and NIPPV are ways of supporting babies breathing in a less invasive way - the tubes are shorter and go only to the back of the nose and, therefore, cause less damage. NCPAP and NIPPV may be used after extubation to reduce the number of babies that need to have the endotracheal tube reinstituted. NCPAP provides steady pressure to the back of the nose which is transmitted to the lungs, helping the baby breath more comfortably. NIPPV provides the same support, but also adds some breaths from the ventilator. The three studies that have compared NCPAP and NIPPV each show that NIPPV reduces the need for the endotracheal tube to be reinstituted. Further studies are needed to make sure NIPPV is safe.