Comparison of three non-invasive ventilation strategies (NSIPPV/BiPAP/NCPAP) for RDS in VLBW infants

Vincenzo Salvo*, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J. I. Zimmermann, Antonio W. D. Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferrau, Diego Gazzolo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Non-invasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness, and failure.Objective: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous positive airway pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV), and nasal bilevel-CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW).Methods: A multicenter retrospective study was conducted in three neonatal intensive care unit (NICUs) that enrolled 191 VLBW infants complicated by RDS, who received, as first intention treatment for RDS, three different NIV approaches (N-CPAP: n=66; N-SIPPV: n=62, BiPAP: n=63). We evaluated the performance of different NIV strategies by primary (failure within the first 5 d of life) and some selected secondary end-points.Results: The incidence of NIV failure was significantly higher in the N-CPAP group (22/66) versus N-SIPPV/BiPAP groups (11/62; 11/63) (p<.05 for both), while no difference was observed between N-SIPPV and BiPAP groups. Moreover, no differences were found between the three groups regarding secondary outcomes.Conclusions: The present study shows that first intention N-SIPPV/BiPAP, as NIV support, augment the beneficial effects of N-CPAP contributing to a reduced risk of failure in VLBW infants complicated by RDS. Data open up to further RCTs on a wider population to evaluate NIV effectiveness on long-term outcomes.
Original languageEnglish
Pages (from-to)2832-2838
Number of pages7
JournalJournal of Maternal-Fetal & Neonatal Medicine
Issue number21
Publication statusPublished - 1 Jan 2018


  • BiLevel-CPAP
  • nasal synchronized intermittent positive pressure ventilation (NSIPPV)
  • nCPAP
  • NIV
  • RDS
  • CPAP

Cite this