{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:15:23Z","timestamp":1779909323058,"version":"3.53.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Approximately half of very preterm infants with respiratory distress syndrome (RDS) fail treatment with nasal continuous positive airway pressure (NCPAP) and need mechanical ventilation (MV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim with this study was to evaluate if nasal intermittent positive pressure ventilation (NIPPV) during less invasive surfactant treatment (LISA) can improve respiratory outcome compared with NCPAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We carried out an open\u2010label randomized controlled trial at tertiary neonatal intensive care units in which infants with RDS born at 25<jats:sup>+0<\/jats:sup>\u221231<jats:sup>+6<\/jats:sup> weeks of gestation between December 1, 2020\u00a0and October 31, 2022 were supported with NCPAP before and after surfactant administration and received NIPPV or NCPAP during LISA. The primary endpoint was the need for a second dose of surfactant or MV in the first 72\u2009h of life. Other endpoints were need and duration of invasive and noninvasive respiratory supports, changes in SpO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratio after\u00a0LISA, and adverse effect rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 101 infants in the NIPPV group and 99 in the NCPAP group. The unadjusted odds ratio for the composite primary outcome was 0.873 (95% confidence interval: 0.456\u20131.671; <jats:italic>p<\/jats:italic>\u2009=\u2009.681). We found that the SpO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratio was transiently higher in the LISA plus NIPPV than in the LISA plus NCPAP group, while adverse effects of LISA had similar occurrence in the two arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The application of NIPPV or NCPAP during LISA in very preterm infants supported with NCPAP before and after surfactant administration had similar effects on the short\u2010term respiratory outcome and are both safe. Our study does not support the use of NIPPV during LISA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26879","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T13:23:27Z","timestamp":1705929807000},"page":"1006-1014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nasal intermittent positive pressure ventilation during less invasive surfactant administration in preterm infants: An open\u2010label randomized controlled study"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1639-621X","authenticated-orcid":false,"given":"Carlo","family":"Dani","sequence":"first","affiliation":[{"name":"Division of Neonatology Careggi University Hospital of Florence Florence Italy"},{"name":"Department of Neurosciences, Psychology, Drug Research, and Child Health University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Ospedale Evangelico Betania of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Barone","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Ospedale Evangelico Betania of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Manna","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Ospedale Evangelico Betania of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Nigro","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Azienda Ospedaliero Universitaria of Cosenza Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Scarpelli","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Azienda Ospedaliero Universitaria of Cosenza Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Bonanno","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit Azienda Ospedaliero Universitaria of Cosenza Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gatto","sequence":"additional","affiliation":[{"name":"Division of Neonatology \u201cV. Buzzi\u201d Children's Hospital\u2014ASST\u2010FBF\u2010Sacco Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cavigioli","sequence":"additional","affiliation":[{"name":"Division of Neonatology \u201cV. Buzzi\u201d Children's Hospital\u2014ASST\u2010FBF\u2010Sacco Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Forcellini","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric and Neonatal intensive Care Unit Azienda Ospedaliera Universitaria Integrata Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Petoello","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric and Neonatal intensive Care Unit Azienda Ospedaliera Universitaria Integrata Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzo","family":"Beghini","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric and Neonatal intensive Care Unit Azienda Ospedaliera Universitaria Integrata Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Ciarci\u00e0","sequence":"additional","affiliation":[{"name":"Division of Neonatology Careggi University Hospital of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Fusco","sequence":"additional","affiliation":[{"name":"Division of Neonatology Careggi University Hospital of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Mosca","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan Milan Italy"},{"name":"Department of Clinical Sciences and Community Health University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lavizzari","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloisa","family":"Gitto","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letteria","family":"Barbuscia","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2635-4945","authenticated-orcid":false,"given":"Pasqua","family":"Betta","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit Azienda Ospedaliero\u2010Universitaria Policlinico\u2014Vittorio Emanuele of Catania 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