Usefulness of DuoPAP in the treatment of very low birth weight preterm infants with neonatal respiratory distress syndrome.

OBJECTIVE: This study examined the usefulness of nasal Duo positive airway pressure (DuoPAP) in the treatment of very low birth weight preterm infants with neonatal respiratory distress syndrome (NRDS).

PATIENTS AND METHODS: Eighty-five very low birth weight preterm infants with NRDS were randomly divided into two groups. Forty-five infants were treated with DuoPAP, while 40 infants were treated using nasal continuous positive airway pressure (nCPAP). The study outcomes were pH, PaCO, PaO₂, oxygenation index (PaO₂/FiO₂), and the number of failure cases at 1, 12, and 24 hours after non-invasive respiratory support.

RESULTS: At all studied time points, after non-invasive respiratory support, PaCO₂, PaO₂ and oxygenation index were significantly (p < 0.05) better in the nasal DuoPAP group compared with nasal CPAP group. In addition, rates of failure of assisted ventilation (respectively, 4.44% vs. 22.50%) and the occurrence of apnea (13.33% vs. 32.50%) were significantly (p < 0.05) better in the nasal DuoPAP group. Other parameters (such as duration of noninvasive ventilation, number of retinopathies of premature children, intraventricular hemorrhages, or periventricular leukomalacias) were comparable between both non-invasive regimen.

CONCLUSIONS: Nasal DuoPAP better improves oxygenation, reduces CO₂ retention, and diminishes the need for invasive mechanical ventilation and complications in the treatment of NRDS.