A Trial Comparing Noninvasive Ventilation Strategies in Preterm Infants

Abstract

Abstract There was evidence from small trials that nasal intermittent positive pressure ventilation (NIPPV) might be a superior mode of respiratory support to nasal continuous positive airway pressure (nCPAP) for preterm infants. The NIPPV Trial randomized 1009 extremely low birth weight (ELBW) infants born before 30 weeks’ gestation to NIPPV or nCPAP, either as early or post-extubation respiratory support. A heterogeneous population was enrolled, involving 34 centers worldwide. This large, pragmatic trial allowed the use of both synchronized and non-synchronized NIPPV. The trial found no difference in the composite primary outcome of death or bronchopulmonary dysplasia at 36 weeks’ postmenstrual age (NIPPV 38.4% versus nCPAP 36.7%; adjusted odds ratio 1.09, 95% confidence interval 0.83 to 1.43, p = 0.56). There were no differences in the individual components of the primary outcome, or in the frequencies of other secondary outcomes, including potential adverse effects of treatment.