Bi-PAP is not superior to NCPAP in the premature twins with respiratory distress syndrome: a prospective cohort study

Abstract

Bi-PAP is not superior to NCPAP in the premature twins with respiratory distress syndrome: a prospective cohort study Xingmei Deng1 , Huiling Cao2,3,4,5,6 , Chunxiu Zhang1 , Hong Yang1 ,Yuan Shi2,3,4,5,6 , Fang Li2,3,4,5,6,*, Chuanfeng Li1,* 1Department of Pediatrics, Qujing Maternal and Child Health Hospital, 655000 Qujing, Yunnan, China 2Department of Neonatology, Children’s Hospital of Chongqing Medical University, 400000 Chongqing, China 3National Clinical Research Center for Child Health and Disorders, 400000 Chongqing, China 4Ministry of Education Key Laboratory of Child Development and Disorders, 400000 Chongqing, China 5China International Science and Technology Cooperation base of Child development and Critical Disorders, 400000 Chongqing, China 6Chongqing Key Laboratory of Pediatrics, 400000 Chongqing, China *Correspondence: qjfyxselcf@163.com (Chuanfeng Li); rematalili@163.com (Fang Li) Academic Editor: Luca Roncati Submitted: 17 November 2021 Revised: 10 January 2022 Accepted: 26 January 2022 Published: 7 April 2022 Abstract Background: Recently, non-invasive ventilation has been widely used due to the reduction of adverse effects of endotracheal intubation. Nevertheless nearly no researches have compared the efficacy of non-invasive respiratory support between preterm twins. The objective of this study was to determine if there is a decreased non-invasive ventilation (NIV) failure from bi-level positive airway pressure (BiPAP) vs nasal continuous positive airway pressure (NCPAP) in preterm twins as initial ventilation. Methods: This prospective cohort study enrolled 100 pairs preterm twins who were admitted to the NICU at Yunnan Qujing Maternity and Child Health Care Hospital from 2017.10 to 2020.09 for respiratory distress syndrome. One of the twin was randomly assigned to Bi-PAP, meanwhile another to NCPAP. The primary outcome was the incidence of NIV failure. Secondary outcomes was the occurrence rate of side-effects of NIV. Results: A total of 100 pairs preterm twins were included in statistical analysis. No distinct differences were found in NIV failure between groups (NCPAP vs Bi-PAP, 5% vs 2%, p = 0.248). We did not find any statistical difference in secondary outcome between Bi-PAP and NCPAP. Conclusions: In this prospective cohort study, among preterm twins with RDS, NCPAP was noninferior to Bi-PAP with respect to the reduction of the need for invasive mechanical ventilation (IMV). Keywords: respiratory distress syndrome; bi-level positive airway pressure; nasal continuous positive airway pressure; preterm twins