Neonatal nasal intermittent positive pressure ventilation: a survey of practice in England

Abstract

Aim: Less invasive techniques of respiratory support are increasingly popular. We aimed to determine how widespread neonatal Nasal Intermittent Positive Airway Pressure (NIPPV) has become, and describe the range of practice used in NIPPV in England.

Methods: Surveys were emailed to 95 Neonatal intensive care units, asking about NIPPV devices, interfaces, indications, guidelines, use of synchronisation, complications, settings and weaning.

Results: Ninety one (96%) replied. NIPPV was used by 48% of units, very few complications were seen. 77% used a synchronising device, 80% used NIPPV for ‘rescuing’ babies failing Continuous Positive Airway Pressure (CPAP), 59% used NIPPV routinely post extubation and 16% as a first line treatment. A wide range of pressure and rate settings were used.

Conclusions: In England, NIPPV is commonly used, with considerable variability in the techniques applied. The range of clinical approaches highlights the paucity of evidence available. More evidence is needed to establish best practice.