PROLONGED INTERMITTENT POSITIVE PRESSURE VENTILATION BY NASAL PRONGS IN INTRACTABLE APNEA OF PREMATURITY

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Abstract
To avoid endotracheal intubation in very small newborn human infants requiring prolonged intermittent positive pressure ventilation (IPPV), a method was developed allowing delivery of IPPV by nasal prongs (nasal IPPV). Newborn infants (10) weighing 1200 g or less, and requiring nasal IPPV for 5-14 days because of intractable apnea, were reported. Five infants survived. With the exception of hearing defects in 2 survivors, no lesions possibly due to the ventilation procedure were observed. Follow-up examination showed severe mental and motor handicap in 1 infant, and apparently normal mental and motor development in 3 infants examined at the age of 12-27 mo. Apparently, nasal IPPV is an effective and safe method for prolonged ventilation of very small newborn infants with normal or not severely affected lungs. Apparently, it has very limited use in patients with stiff lungs, such as severe HMD [hyaline membrane disease].