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Extubation Success in Premature Infants With Respiratory Distress Syndrome Treated With Bi-Level Nasal Continuous Positive Airway Pressure Versus Nasal Intermittent Positive Pressure Ventilation

Thomas, Patricia E. PhD, RN, NNP-BC; LeFlore, Judy PhD, RN, NNP-BC, CPNP-AC & PC, ANEF, FAAN

Journal of Perinatal & Neonatal Nursing: October/December 2013 - Volume 27 - Issue 4 - p 328–334
doi: 10.1097/JPN.0b013e3182a983f0
FEATURE ARTICLES: Continuing Education

Infants born prematurely with respiratory distress syndrome are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with 2 different types of continuous positive airway pressure devices. A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, level III neonatal intensive care unit. A sample of 194 premature infants with respiratory distress syndrome was selected, 124 of whom were treated with nasal intermittent positive pressure ventilation and 70 with bi-level variable flow nasal continuous positive airway pressure (bi-level nasal continuous positive airway pressure). Infants in both groups had high extubation success rates (79% of nasal intermittent positive pressure ventilation group and 77% of bi-level nasal continuous positive airway pressure group). Although infants in the bi-level nasal continuous positive airway pressure group were extubated sooner, there was no difference in duration of oxygen therapy between the 2 groups. Promoting early extubation and extubation success is a vital strategy to reduce complications of mechanical ventilation that adversely affect premature infants with respiratory distress syndrome.

College of Nursing, University of Texas at Arlington, Arlington, Texas (Drs Thomas and LeFlore); and Pediatrix Medical Group, Dallas, Texas (Dr Thomas). The authors acknowledge the contribution of Daisha Cipher, PhD, Clinical Associate Professor, College of Nursing, University of Texas at Arlington. Her recommendations on statistical analyses and presentation of results were invaluable.

Corresponding Author: Patricia E. Thomas, PhD, RN, NNP-BC, College of Nursing, University of Texas at Arlington, 411 S. Nedderman Dr, Box 19407, Arlington, TX 76019 (pthomas@uta.edu).

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: June 3, 2012; accepted for publication: February 21, 2013.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins.