Comparison of nasal masks or binasal prongs for delivering continuous positive airway pressure in preterm neonates of gestational age less than 32 weeks

Touseef Ul Ayoub; Athar Ur Nisa Quraishi

doi:10.18203/2349-3291.ijcp20242737

Authors

Touseef Ul Ayoub Department of Pediatric Cardiology, Fortis Escorts Heart Institute, New Delhi, India
Athar Ur Nisa Quraishi Department of Neuroanesthesia, SKIMS Soura, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242737

Keywords:

Preterm, Respiratory distress, NCPAP, Mechanical ventilator, Nasal mask, Nasal prongs

Abstract

Background: Aim was to compare the efficacy and safety of continuous positive airway pressure (CPAP) delivered by nasal masks vs binasal prongs.

Methods: This was observational trial where preterm infants less than 32 weeks of gestation with respiratory distress were enrolled after parental consent. Participants: 145 neonates less than 32 weeks gestation requiring nasal CPAP (NCPAP) as a primary mode for respiratory distress, who were treated with either nasal mask (n=45) or nasal prongs (n=99) as interface. Primary outcome: Was the incidence of CPAP failure (need for mechanical ventilation at less than 72 hours).

Results: Failure rate in nasal mask group was 13% vs nasal prongs group was 39.4% and the difference was statistically significant. Secondary outcomes were mean FiO₂ requirement at 6 hours, duration of CPAP therapy, hospital stay and nasal trauma. There was 3.7±5.78% reduction in oxygen requirement at 6 hours of CPAP initiation with nasal mask as compared to nasal prongs and the difference was statistically significant (p<0.05). the CPAP duration in nasal mask group was 3.4± 4.04 days vs nasal prongs group was 4.5±3.52 days and duration of hospital stay in nasal mask group was 15.4±14.19 vs in nasal prongs group was 20.2±13.86 and the both differences were also statistically significant(p<0.05). Nasal mask had no nasal injury (0%) as compared to infants on nasal prongs (23.2%) and the difference was statistically significant (p<0.05).

Conclusions: NCPAP with mask as interface is as effective as prongs but causes less nasal trauma and less CPAP duration and hospital stay.

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