الفهرس 
Introduction and Aim of WorkOnly 14 pages are availabe for public view
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Abstract
Prolonged use of mechanical ventilation has been associated with infections, chronic lung disease, subglottic stenosis and aspiration. Considerable effort is therefore directed towards early weaning from the ventilator (Robertson and Hamilton, 1998). Continuous positive airway pressure (CPAP) frequently is used to wean infants from mechanical ventilation. The common modalities of delivering CPAP are through nasal prongs (NCPAP), nasopharyngeal tube (NPCPAP), endotracheal tube, or face mask (Khalaf et al., 2001). A recent systematic review showed NCPAP to be effective in preventing symptoms of extubation failure (Davis and Henderson-Smart, 2002). However, nearly 28% of infants being extubated to NCPAP failed, justifying the development of methods to augment the known beneficial effects of NCPAP (Morley, 1999). Nasal intermittent positive pressure ventilation (NIPPV) is a mode of ventilation that combines nasal continuous positive airway pressure with superimposed ventilator breaths. It can be administered using the same systems used to deliver NCPAP, at either the nasal or nasopharyngeal level. The clinical need to reduce the duration of endotracheal intubation and the recent ability to synchronize ventilator support with the spontaneous breaths of infants have led to the use of NIPPV (De Paoli et al.,2003b). In this study we aimed to determine whether nasal intermittent positive pressure ventilation would decrease the incidence of extubation failure compared with nasal continuous positive airway pressure in ventilated infants and to study the effect of both techniques on the frequency of post extubation apnea, development of bronchopulmonary dysplasia, duration of oxygen therapy and gastrointestinal perforations. This study was conducted in NICU, MUCH upon preterm babies who were ventilated with exclusion of those with congenital defects or inborn errors of metabolism in the period between October 2004 and August 2005. They were randomly and retrospectively divided into two groups according to the mode used in weaning: NCPAP group (20 patients) and SNIPPV group (20 patients). All patients were subjected to the following: history taking including perinatal and obstetric history, physical examination, radiologic assessment, and laboratory investigations in the form of serial arterial blood gases, full blood count, C-reactive protein, blood culture and electrolytes. We found no significant difference between both modes regarding success of weaning or survival of babies so both NCPAP and SNIPPV can be used to facilitate weaning and reduce the need for reventilation.