urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.3.71LIZPMOurmj-2232Research ArticleОригинальные статьи | Original articlesOriginal articlesСовременные методы неинвазивной вентиляции легких у недоношенных с респираторным дистресс-синдромом: возможности, преимущества и ограниченияModern Methods of Non-invasive Ventilation in Preterm Infants with Respiratory Distress Syndrome: Opportunities, Advantages, and Limitationshttps://orcid.org/0000-0002-7906-508XФигольС. Ю.FigolS. Y.

Сергей Юрьевич Фиголь — заведующий отделением реанимации и интенсивной терапии новорожденных, Приморский краевой перинатальный центр; ассистент института педиатрии, Тихоокеанский государственный медицинский университет 

Владивосток 

Sergei Y. Figol  — Head of the Neonatal Intensive Care Department, Primorsky Krai Perinatal Center; Assistant Professor of the Institute of the Pediatrics, Pacific State Medical University

Vladivostok 

figolsergei@yandex.ruhttps://orcid.org/0000-0003-2668-8483ШуматоваТ. А.ShumatovaT. A.

Татьяна Александровна Шуматова — доктор медицинских наук, профессор, директор института педиатрии 

Владивосток 

Tatyana A. Shumatova — Doctor of Sciences (Medicine), Professor, Director of the Institute of Pediatrics 

Vladivostok 

shumatov@mail.ruhttps://orcid.org/0000-0002-7040-9683МостовойА. В.MostovoyA. V.

Алексей Валерьевич Мостовой — доктор медицинских наук, руководитель службы реанимации и интенсивной терапии, Городская клиническая больница № 67 имени Л. А. Ворохобова; доцент кафедры неонатологии имени профессора В. В. Гаврюшова, Российская медицинская академия непрерывного профессионального образования; ассистент кафедры поликлинической терапии, клинической лабораторной диагностики и медицинской биохимии, Ярославский государственный медицинский университет 

Москва 

Ярославль 

Aleksey V. Mostovoy — Doctor of Sciences (Medicine), Head of the Resuscitation and Intensive Care Service, City Clinical Hospital No. 67 named after L. A. Vorokhobov; Associate Professor of the Department of Neonatology named after Professor V.V. Gavryushov, Russian Medical Academy of Continuous Professional Education; Assistant Professor of the Department of Outpatient Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University

Moscow 

Yaroslavl 

valmost@mail.ruhttps://orcid.org/0000-0002-1024-0230КарповаА. Л.KarpovaA. L.

Анна Львовна Карпова — кандидат медицинских наук, заведующий неонатологическим стационаром, Городская клиническая больница № 67 имени Л. А. Ворохобова; доцент кафедры неонатологии имени профессора В. В. Гаврюшова, Российская медицинская академия непрерывного профессионального образования; ассистент кафедры поликлинической терапии, клинической лабораторной диагностики и медицинской биохимии, Ярославский государственный медицинский университет 

Москва 

Ярославль 

Anna L. Karpova — Doctor of Sciences (Medicine), Head of the Neonatology Department, City Clinical Hospital No. 67 named after L. A. Vorokhobov; Associate Professor of the Department of Neonatology named after Professor V.V. Gavryushov, Russian Medical Academy of Continuous Professional Education; Assistant Professor of the Department of Outpatient Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University

Moscow 

Yaroslavl 

anna1409@mail.ruПриморский краевой перинатальный центр; Тихоокеанский государственный медицинский университетРоссияPrimorsky Regional Perinatal Center; Pacific State Medical UniversityRussian FederationТихоокеанский государственный медицинский университетРоссияPacific State Medical UniversityRussian FederationГородская клиническая больница № 67 имени Л. А. Ворохобова; Российская медицинская академия непрерывного профессионального образования; Ярославский государственный медицинский университетРоссияCity Clinical Hospital No. 67 named after L. A. Vorokhobov; Russian Medical Academy of Continuous Professional Education; Yaroslavl State Medical UniversityRussian Federation20260207202625371–88Copyright © Фиголь С.Ю., Шуматова Т.А., Мостовой А.В., Карпова А.Л., 20262026Фиголь С.Ю., Шуматова Т.А., Мостовой А.В., Карпова А.Л.Figol S.Y., Shumatova T.A., Mostovoy A.V., Karpova A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2232Актуальность

Актуальность. Респираторный дистресс-синдром новорожденных (РДС) остается основной причиной дыхательной недостаточности у недоношенных детей, а бронхолегочная дисплазия (БЛД) — самым частым и тяжелым осложнением респираторной терапии. Применение неинвазивной вентиляции легких (NIV) является основой стратегии «защитной вентиляции легких», направленной на предотвращение ятрогенного повреждения и снижение риска развития БЛД.

Цель обзора

Цель обзора. Обобщить и проанализировать современные данные о методах NIV у недоношенных новорожденных с РДС, делая акцент на клинические возможности каждого метода, их преимущества и ограничения для оптимизации респираторной тактики.

Материалы и методы

Материалы и методы. Поиск проводился в следующих зарубежных и российских электронных библиографических базах данных и реестрах: PubMed, Cochrane Central Register of Controlled Trials, научная электронная библиотека eLibrary.ru и «КиберЛенинка». Основной период поиска, охватывал публикации за последнее десять лет (2015–2025 гг.).

Результаты

Результаты. Эволюция методов неинвазивной респираторной поддержки направлена на достижение максимальной синхронизации с дыханием пациента и обеспечение стабильного давления в дыхательных путях. Сравнительные исследования и метаанализы демонстрируют превосходство синхронизированных режимов SNIPPV над базовым NСРАР в предотвращении интубации, а NHFOV может быть наиболее эффективным методом постэкстубационной поддержки. Однако применение этих методов сопряжено с рисками, включая назальные повреждения, баротравму и влияние на гемодинамику.

Заключение

Заключение. Успешное внедрение NIV требует персонализированного подхода, основанного на гестационном возрасте, тяжести состояния и постоянной оценке клинических исходов, таких как развитие БЛД, потребность в инвазивной вентиляции легких и выживаемости. 

Background

Background. Neonatal respiratory distress syndrome (RDS) remains the leading cause of respiratory failure in preterm infants, while bronchopulmonary dysplasia (BPD) is the most frequent and severe complication of respiratory therapy. The use of non-invasive ventilation (NIV) is a cornerstone of the “lung-protective ventilation” strategy aimed at preventing iatrogenic injury and reducing the risk of BPD.

Objective is to summarize and analyze current evidence on NIV methods in preterm neonates with RDS, focusing on the clinical capabilities of each technique, their advantages, and limitations to optimize respiratory management.

Materials and methods

Materials and methods. The search was conducted in the following foreign and Russian electronic bibliographic databases and registries: PubMed, Cochrane Central Register of Controlled Trials, Scientific Electronic Library eLibrary.ru and CyberLeninka. The primary search period covered publications from the last ten years (2015–2025).

Results

Results. The evolution of non-invasive respiratory support methods aims to achieve maximum patient-ventilator synchrony and stable airway pressure. Comparative studies and meta-analyses demonstrate the superiority of synchronized modes (SNIPPV) over basic NCPAP in preventing intubation, while NHFOV may be the most effective method for post-extubation support. However, the use of these methods is associated with risks, including nasal injuries, barotrauma, and hemodynamic effects.

Conclusion

Conclusion. Successful implementation of NIV requires a personalized approach based on gestational age, disease severity, and continuous assessment of clinical outcomes such as BPD development, need for invasive mechanical ventilation, and survival. 

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The authors declare that there are no conflicts of interest present.