Respiratory Distress Syndrome (RDS) is a common complication in premature infants, primarily due to the underdevelopment of their lungs and insufficient production of surfactant, which helps keep the airways open. This condition can lead to difficulty in breathing and requires immediate medical intervention. Traditionally, Invasive mechanical ventilation has been a standard treatment, but it comes with significant risks and complications, including Lung injury.
In recent years, Non Invasive Positive Pressure Ventilation (NIPPV) has emerged as a beneficial alternative for treating RDS in premature infants.
NIPPV is a respiratory support system that provides positive pressure to assist in breathing without the need for an endotracheal tube, which is commonly used in invasive mechanical ventilation. NIPPV uses nasal prongs or masks to deliver continuous or intermittent positive pressure to the lungs, aiding in gas exchange while minimizing the risk of lung injury.
There are some benefits of NIPPV for Premature Infants with Respiratory Distress Syndrome, include:
Reduced Lung Injury
One of the primary benefits of NIPPV over traditional mechanical ventilation is the lower risk of lung injury, also known as Ventilator Associated Lung Injury (VALI). Premature infants have fragile lungs, and invasive ventilation can cause damage due to high pressure (barotrauma) and damage from overdistension of the lungs (volutrauma). NIPPV delivers gentle and controlled pressure, significantly reducing the risk of these complications.
Enhanced Oxygenation & Ventilation
NIPPV supports effective oxygenation and ventilation by helping maintain Functional Residual Capacity (FRC) in the lungs. This ensures that the lungs remain inflated at the end of exhalation, improving oxygen exchange and reducing episodes of apnea or pauses in breathing in premature infants.
Decreased need for Invasive Ventilation
NIPPV can often prevent the need for intubation and mechanical ventilation in many premature babies with mild to moderate RDS. By providing early respiratory support with NIPPV, infants may stabilize without the need for more invasive measures, leading to improved outcomes and less trauma associated with intubation.
Prevention of Bronchopulmonary Dysplasia (BPD)
BPD is a chronic lung condition that can develop in preterm infants after prolonged mechanical ventilation. By reducing the need for invasive ventilation and minimizing lung injury, NIPPV lowers the risk of developing BPD, which is associated with long-term respiratory problems and developmental issues.
Minimized Infections & Complications
Endotracheal intubation increases the risk of infections such as Ventilator Associated Pneumonia (VAP) in premature infants. Since NIPPV is non-invasive, it significantly reduces the chance of such infections, contributing to better overall outcomes and shorter stays in the neonatal intensive care unit (NICU).
Improved Comfort and Bonding
Non-invasive ventilation is generally more comfortable for the infant compared to invasive mechanical ventilation. Babies on NIPPV can often be held by their parents, which promotes bonding and reduces parental anxiety. The ability to provide kangaroo care (skin-to-skin contact) while on NIPPV is also a major advantage, as this type of care is associated with numerous benefits for premature infants, including improved weight gain and stability of vital signs.
Cost Effectiveness
NIPPV is generally less resource-intensive compared to mechanical ventilation, both in terms of equipment and the need for specialized staff. This can make it a more cost-effective option for hospitals, while also reducing the overall healthcare burden.
As Conclusion, NIPPV has proven to be an effective and safer alternative to invasive mechanical ventilation for premature infants with Respiratory Distress Syndrome. By reducing the risk of lung injury, infections, and other complications, NIPPV offers a better quality of care and improved outcomes for vuln erable newborns. Its non invasive nature, combined with enhanced oxygenation, makes it a first-line therapy in the management of RDS in many neonatal intensive care units. (IW 1809)