• Carlo Dani, Giulia Fontanelli, Ilaria Lori, Federica Favelli, and Chiara Poggi.
• Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Italy. cdani@unifi.It
• J. Matern. Fetal. Neonatal. Med. 2013 Apr 1; 26 (6): 603-7.

ObjectivesOur aim was to assess whether non-invasive ventilation with heliox may decrease the incidence of extubation failure in preterm infants with RDS.MethodsInfants <29 weeks of gestation were treated immediately after extubation with heliox combined with nasal continuous airway pressure (Hx-NCPAP) or bilevel NCPAP (Hx-BiPAP) for 24 h, while infants in the control groups were treated with conventional NCPAP or BiPAP. The primary endpoint was the comparison of the extubation failure rate in the two groups, where failure was defined as the need for MV during the 24 h following extubation.ResultsEighteen infants were assigned to the heliox group and 18 to the control group. The extubation failure rate was similar (p = 0.249) in the heliox (n = 6; 33%) and in the control group (n = 9; 50%), but required mean airway pressure (MAP: 4.0+1.0 vs. 4.8+1.2 cm H2O; p = 0.037) and PaCO2 (39+8 mmHg vs. 52+7 mmHg; p < 0.001) at 24 h of treatment were lower in the heliox group.ConclusionsNon-invasive ventilation with heliox was not effective in decreasing extubation failure in preterm infants with RDS, but did improve their respiratory function. Our findings might support the planning of large randomized controlled studies to evaluate the effectiveness of heliox non-invasive ventilation for decreasing extubation failure in premature infants.

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