Modern Methods of Non-invasive Ventilation in Preterm Infants with Respiratory Distress Syndrome: Opportunities, Advantages, and Limitations
https://doi.org/10.52420/umj.25.3.71
EDN: LIZPMO
Abstract
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. 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. 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. 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.
Keywords
neonatal respiratory distress syndrome,
preterm infants,
non-invasive respiratory support,
nasal continuous positive airway pressure,
nasal intermittent positive pressure ventilation,
non-invasive high frequency oscillatory ventilation,
bronchopulmonary dysplasia,
lung protective ventilation
About the Authors
S. Y. Figol
Primorsky Regional Perinatal Center; Pacific State Medical University
Russian Federation
Competing Interests:
Russian Federation
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
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
T. A. Shumatova
Pacific State Medical University
Russian Federation
Competing Interests:
Russian Federation
Tatyana A. Shumatova — Doctor of Sciences (Medicine), Professor, Director of the Institute of Pediatrics
Vladivostok
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
A. V. Mostovoy
City Clinical Hospital No. 67 named after L. A. Vorokhobov; Russian Medical Academy of Continuous Professional Education; Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
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
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
A. L. Karpova
City Clinical Hospital No. 67 named after L. A. Vorokhobov; Russian Medical Academy of Continuous Professional Education; Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
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
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
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Figol SY, Shumatova TA, Mostovoy AV, Karpova AL. Modern Methods of Non-invasive Ventilation in Preterm Infants with Respiratory Distress Syndrome: Opportunities, Advantages, and Limitations. Ural Medical Journal. 2026;25(3):71–88. (In Russ.) https://doi.org/10.52420/umj.25.3.71. EDN: LIZPMO
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