A Comparative Randomised Controlled Study between Efficacy of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation on Neonates with Meconium Aspiration Syndrome

Background: Meconium aspiration syndrome (MAS) is an important cause of neonatal respiratory distress and morbidity in term and post‑term neonates. Non‑invasive ventilation strategies such as nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) are increasingly used to reduce the need for invasive mechanical ventilation. Aim: To compare the efficacy of NCPAP and NIPPV as initial respiratory support in neonates with meconium aspiration syndrome. Methods: A hospital‑based randomized controlled trial was conducted on 60 neonates with MAS admitted to the NICU of Hassan Institute of Medical Sciences between March 2021 and December 2022. Neonates were randomly allocated into two groups: NIPPV (n=30) and NCPAP (n=30). Respiratory parameters, need for mechanical ventilation, surfactant therapy, complications and duration of hospital stay were compared between the groups. Results: Duration of hospital stay was significantly lower in the NIPPV group compared to the NCPAP group (25.53±7.37 vs 39.67±7.24 days; p<0.05). Mechanical ventilation was required in 16 (53.3%) neonates in the NIPPV group and 19 (63.3%) neonates in the NCPAP group. Surfactant therapy was administered in 6 (20%) and 3 (10%) neonates respectively. These differences were not statistically significant (p>0.05). Conclusion: Both NIPPV and NCPAP are effective non‑invasive respiratory support strategies for neonates with MAS. NIPPV appears to reduce the duration of hospitalization and can be considered a safe and effective alternative to NCPAP in the management of MAS.