Non-invasive pulmonary ventilation in the treatment of neonatal respiratory distress syndrome

Objective. To assess the effectiveness of differentiated approach and the safety of non-invasive ventilation in the DuoPAP mode in infants with respiratory distress syndrome and extremely low birth weight in the early neonatal period. Patients and methods. A retrospective and prospective analysis in the period from January 2018 to April 2020. 80 children were included in the study (46 girls and 34 boys), who were born prematurely at the gestational age of 24 to 29 weeks with a body weight of 700 to 999 grams and with the main clinical nosology of the early neonatal period – respiratory distress syndrome (68.7%; n = 55) and congenital pneumonia (31.3%; n = 25). Results. The clinical manifestations and features of the diagnosis of respiratory distress syn-drome in premature infants with extremely low body weight in the early neonatal period were studied. A differentiated approach to the tactics of conducting initial respiratory therapy in the ventilation mode with biphasic positive airway pressure was presented. Indications, contraindications and clinical and laboratory predictors of the effective and safe implementation of initial respiratory support in the DuoPAP mode (analogous to the BiPAP regimen) in premature infants with respiratory distress syndrome were formed. Conclusion. Generation of indications, contraindications and timely developed clinical and laboratory predictors make it possible to personify the initial tactics of respiratory therapy in premature infants with extremely low body weight in the conditions of neonatal intensive care unit. A differentiated approach to initial non-invasive ventilation in infants with respiratory distress syndrome is an important preventive tool to minimize ventilator-associated lung injury and intraventricular hemorrhage in the early neonatal period. Key words: premature birth, premature infants, extremely low body weight, respiratory support, respiratory distress syndrome in infants, non-invasive mechanical ventilation, surfactant