BACKGROUND: Synchronized nasal intermittent positive-pressure ventilation (SNIPPV) use reduces reintubation rates compared with nasal continuous positive airway pressure (NCPAP). Limited information is available on the outcomes of infants managed with SNIPPV.OBJECTIVES: To compare the outcomes of infants managed with SNIPPV (postextubation or for apnea) to infants not treated with SNIPPV at 2 sites.METHODS: Clinical retrospective data was used to evaluate the use of SNIPPV in infants ≤1250 g birth weight (BW); and 3 BW subgroups (500–750, 751–1000, and 1001–1250 g, decided a priori). SNIPPV was not assigned randomly. Bronchopulmonary dysplasia (BPD) was defined as treatment with supplemental oxygen at 36 weeks' postmenstrual age.RESULTS: Overall, infants who were treated with SNIPPV had significantly lower mean BW (863 vs 964 g) and gestational age (26.4 vs 27.9 weeks), more frequently received surfactant (85% vs 68%), and had a higher incidence of BPD or death (39% vs 27%) (all P .01) compared with infants treated with NCPAP. In the subgroup analysis, SNIPPV was associated with lower rates of BPD (43% vs 67%; P = .03) and BPD/death (51% vs 76%; P = .02) in the 500- to 750-g infants, with no significant differences in the other BW groups. Logistic regression analysis, adjusting for significant covariates, revealed infants with 500–700-g BW who received SNIPPV were significantly less likely to have the outcomes of BPD (OR: 0.29 [95% CI: 0.11–0.77]; P = .01), BPD/death (OR: 0.30 [95% CI: 0.11–0.79]; P = .01), neurodevelopmental impairment (NDI) (OR: 0.29 [95% CI: 0.09–0.94]; P = .04), and NDI/death (OR: 0.18 [95% CI: 0.05–0.62]; P = .006).CONCLUSION: SNIPPV use in infants at greatest risk of BPD or death (500–750 g) was associated with decreased BPD, BPD/death, NDI, and NDI/death when compared with infants managed with NCPAP.
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机译：背景：与鼻持续气道正压通气（NCPAP）相比，同步鼻间断正压通气（SNIPPV）的使用降低了再插管率。目的：比较SNIPPV治疗的婴儿的结局信息。目的：比较SNIPPV治疗的婴儿（拔管后或呼吸暂停）与未在两个部位接受SNIPPV治疗的婴儿的结果。方法：使用临床回顾性数据评估SNIPPV在体重≤1250 g（BW）的婴儿中的使用;和3个BW子组（500-750、751-1000和1001-1250 g，先验确定）。 SNIPPV不是随机分配的。支气管肺发育不良（BPD）的定义是在月经后36周时补充氧气。结果：总体而言，接受SNIPPV治疗的婴儿的平均BW（863 vs 964 g）和胎龄（26.4 vs 27.9周）明显较低，与接受NCPAP治疗的婴儿相比，接受表面活性剂的频率更高（85％比68％），BPD或死亡的发生率更高（39％比27％）（所有P <.01）。在亚组分析中，在500至750克婴儿中，SNIPPV与较低的BPD发生率（43％比67％; P = .03）和BPD /死亡（51％对76％; P = .02）相关。 ，其他BW组之间没有显着差异。 Logistic回归分析（校正了显着的协变量）显示，接受SNIPPV的体重为500-700 g体重的婴儿发生BPD的可能性大大降低（OR：0.29 [95％CI：0.11-0.77]; P = 0.01） ，BPD /死亡（OR：0.30 [95％CI：0.11-0.79]; P = 0.01），神经发育障碍（NDI）（OR：0.29 [95％CI：0.09-0.94]; P = .04），以及NDI /死亡（OR：0.18 [95％CI：0.05–0.62]; P = .006）。结论：SNIPPV在BPD或死亡风险最高（500–750 g）的婴儿中使用与BPD降低，BPD /与接受NCPAP治疗的婴儿相比，婴儿的死亡，NDI和NDI /死亡。
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