INSURE Procedure Efficacy in Preterm Infants with Respiratory Distress Syndrome Undergoing Nasal CPAP or Bilevel Nasal CPAP

Nasal continuous positive airway pressure (NCPAP) and Bi-level NCPAP (providing two levels of CPAP) are used in preterm infants with RDS. INSURE (INtubation-SURfactant-Extubation) procedure improves respiratory outcome and reduces the need for mechanical ventilation (MV). Volumes optimization after surfactant administration modifies spatial distribution of ventilation. Our target is to evaluate the need for MV in preterm infants undergoing NCPAP or Bilevel NCPAP after INSURE procedure for RDS. Bilevel NCPAP reduced the need for mechanical ventilation, the lenght of respiratory support and of O2 dependency after INSURE procedure. This result suggests that two alternating CPAP levels lead to a better lung volume recruitment after surfactant administration.