The aim of the present work is to study the cardio-respiratory effects of non-invasive ventilation (nasal high-frequency ventilation and nasal CPAP) as an initial therapy of respiratory distress in moderate and late preterm infants as regard: I. Primary outcomes: * Duration of the non- invasive respiratory support. * Need of invasive ventilation in the first 72 hours. * Short-term complications such as air leak syndromes, pulmonary hemorrhage, intraventricular hemorrhage, and nasal trauma. II. Secondary outcomes: * Need for surfactant administration. * Days on invasive mechanical ventilation. * Days on supplemental oxygen. * Duration of hospital stay. * Mortality rate. III. Hemodynamic changes during the period of non-invasive ventilation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Neonatal Intensive Care Unit (NICU) of Alexandria University Maternity Hospital.
Alexandria, Egypt
Superior vena cava blood flow in ml/kg/min
The SVC diameter will be visualized from a high parasternal long axis view. The maximum and minimum internal diameters will be then measured. ✓ The SVC flow velocity will be visualized from a low subcostal view and the pulsed Doppler recording will be made at the junction of the SVC and the right atrium. ✓ SVC flow will be calculated using the method described by Kluckow and Evans:(27) SVC flow (ml/kg/min) = \[VTI (cm/beat) × 3.14 × (mean SVC diameter2 /4) × heart rate (beat/min)\] Body weight in kg 11
Time frame: first 3 days of life
Right ventricular output in ml /kg/min
CSA (cm) (Cross sectional area of PV by long axis parasternal RV outflow view - 2D - immediately beneath pulmonary annulus \- mid- systole - inner edge to inner edge) = π x (radius)2 ✓ VTI (cm) (Velocity Time Integral or Stroke Distance = Distance over which blood travels in once cardiac cycle → Long axis parasternal RV outflow view). ✓ SV (ml/beat) (Stroke Volume = CSA x VTI). ✓ Output (L/min.) COP = SV x HR.
Time frame: first 3 days of life
left ventricular output in ml/kg/min
CSA (cm) (Cross sectional area of AV by long axis parasternal view - 2D - immediately beneath aortic annulus - mid- systole - inner edge to inner edge) = π x (radius) 2 . ✓ VTI (cm) (Velocity Time Integral or Stroke Distance = Distance over which blood travels in once cardiac cycle → Apical 5- chamber view). ✓ SV (ml/beat) (Stroke Volume = CSA x VTI). ✓ Output (L/min.) COP = SV x HR
Time frame: first 3 days of life
peak systolic velocity in anterior cerebral artery in cm/sec
Trans-frontellar cranial sonography using Doppler study
Time frame: first 3 days of life
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.