Although neonatal nasal intermittent positive pressure ventilation (NIPPV) is widely used today, its place in neonatal respiratory support is yet to be fully defined. Current evidence indicates that NIPPV after extubation of very premature infants reduces the rate of reintubation. However, much is still not known about NIPPV including its mechanisms of action. It may improve pulmonary mechanism...

Intermittent positive pressure ventilation through an endotracheal or tracheostomy tube has been the mainstay of respiratory assistance for several decades. Some patients have been discharged home with a positive pressure device and tracheostomy but the number treated by these means in Britain has always been small.' Securing adequate gas exchange is usually easy and differs very little from th...

Preterm infants (PIs) often require respiratory support due to surfactant deficiency. Early weaning from mechanical ventilation to noninvasive respiratory support decreases ventilation-associated irreversible lung damage. This wean is particularly challenging in PIs with cleft lip and cleft palate due to anatomical difficulties encountered in maintaining an adequate seal for positive pressure v...

BACKGROUND The primary aim of this randomized study was to describe the feasibility of early administration of surfactant via a thin catheter during spontaneous breathing (Take Care) and compare early mechanical ventilation (MV) requirement with the InSurE (Intubate, Surfactant, Extubate) procedure. METHODS Preterm infants, who were <32 weeks and stabilized with nasal continuous positive airw...

BACKGROUND To reduce the risk of bronchopulmonary dysplasia in extremely-low-birth-weight infants, clinicians attempt to minimize the use of endotracheal intubation by the early introduction of less invasive forms of positive airway pressure. METHODS We randomly assigned 1009 infants with a birth weight of less than 1000 g and a gestational age of less than 30 weeks to one of two forms of non...

The influence of intermittent positive pressure ventilation on gastro-oesophageal reflux in preterm infants is not known. In many neonatal units, however, concern that ventilation may increase gastro-oesophageal reflux (and therefore aspiration) leads to avoidance of enteral feeding during ventilation. We have therefore performed a crossover study of gastrooesophageal reflux by monitoring lower...

We have investigated the effect of giving two 25 mg doses of dry surfactant powder to the airways of 10 preterm babies with severe idiopathic respiratory distress syndrome requiring intermittent positive pressure ventilation. No useful change in static total compliance or blood gases was seen. We conclude that dry surfactant powder does not have a role in the management of severe idiopathic res...