Pressão positiva continua em vias aéreas (cpap) aplicadas em recém nascidos prematuros: uma revisão da literatura

Abstract

INTRODUCTION: Prematurity imposes significant respiratory challenges in preterm newborns (PTNBs), with Respiratory Distress Syndrome (RDS) as a major cause of morbidity and mortality. Noninvasive ventilation (NIV), including CPAP (Continuous Positive Airway Pressure) and NIPPV (Noninvasive Positive Pressure Ventilation), has been shown to be crucial in the respiratory support of these neonates. OBJECTIVE: To analyze the use of NIPPV and CPAP in the current literature on PTNBs, identifying gaps in existing knowledge. METHODOLOGY: A literature review was carried out in the PubMed and CAPES Journal Portal databases, from March to September 2024. Review articles, randomized clinical trials, cohort studies, systematic reviews, and meta-analyses published between 2020 and 2024, in English and Portuguese, were included. RESULTS: The review indicated that very preterm infants tend to benefit more from NIPPV, with reduced extubation failure rates, decreased time to resolution of Transient Tachypnea of the Newborn (TTRN) and hospitalization time. CPAP, especially bubble CPAP, showed optimization of oxygenation and reduced need for surfactant, although with a higher risk of nasal lesions. DISCUSSION: The CPAP and NIPPV respiratory support modalities have distinct applicability and specific advantages, with bubble CPAP proving to be superior in optimizing oxygenation. CONCLUSION: NIPPV and CPAP are valuable tools in respiratory support of preterm infants, with NIPPV being more effective in extremely preterm infants and bubble CPAP standing out in optimizing oxygenation.