Use of Non-Invasive Ventilation in Reducing Partial Pressure of Carbon Dioxide Level (PaCO2) in Neonates with Respiratory Distress Syndrome

Abstract

Objective: It has been observed that non-invasive ventilation used in premature with Respiratory distress syndrome and notably decrease level of partial pressure of carbon-dioxide (PaCO2 ) level in blood. The primary goal of this study was to assess the effect of non-invasive ventilation in decreasing the level of partial pressure of carbon dioxide (PaCO2 ) level and supplementary oxygen need in premature neonates with RDS. Study Design and Settings: This randomized controlled trial was done in Jan 2021 till August 2021 at PNS SHIFA Karachi. Methodology: Neonates with gestational age (GA <34 wk) with RDS at birth were randomly assigned to nasal intermittent positive pressure ventilation (NIPPV) and nasal high frequency oscillatory ventilation (NHFOV) for respiratory support after giving surfactant .Twenty three preterm babies were included in each group .Level of partial pressure of carbon dioxide at 2hrs and 24hrs of non-invasive ventilation and supplementary oxygen need was evaluated. Results: Non-invasive ventilation was found to reduce the PaCO2 level (p= .01), NIPPV (43.06±13.74) vs. (33.63±19.99) in NHFOV at 2hrs and 24hrs NIPPV (19.89±7.18) vs. NHFOV (14.04±8.39).Value of pH was also significant in two groups with optimal mean airway pressure. Supplementary oxygen period were also reduced in NHFOV than NIPPV group (35.7% vs. 64.3%). Conclusion: NHFOV was a beneficial mode in maintaining level of pH, PaCO2 level and reducing need of supplementary oxygen in preterm babies with RDS.