Introduction: Respiratory distress syndrome (RDS) is the most common respiratory morbidity in preterm infants, despite surfactant therapy has become the standard of care in preterm infants with RDS, up to 40% of neonates with RDS may need intubation and mechanical ventilation. The aim of the work: was to evaluate whether nasal intermittent positive pressure ventilation (NIPPV) is more successful than nasal continuous positive airway pressure (NCPAP) for management of preterm infants with respiratory distress syndrome (RDS) decreasing the requirement for endotracheal ventilation or not, and to compare the related complications and outcomes. Patients and methods: The present comparative study included Seventy one preterm neonates with RDS delivered and admitted to neonatal intensive care units of Al Hussein University Hospital and Ahmed Maher Teaching Hospital from October 2014 till November 2015. They were selected by simple random method, sixty patients were enrolled in the study & classified into 2 groups, NCPAP group (n=31) and NIPPV group (n=29). Detailed history-taking, thorough examination and laboratory data were obtained. The results showed: Those 24 (82.8 %) patients showed NIPPV success with 5 (17.2 %) patients needed endotracheal ventilation versus 22 (71 %) patients showed NCPAP success with 9 (29 %) patients needed endotracheal ventilation. Also, 25 (86.2 %) patients survived and 4 (13.7 %) patients expired among the NIPPV group versus 24 (77.4 %) patients survived, and 7 (22.6 %) patients expired among the NCPAP group. NIPPV group showed less duration of O2 need and hospital stay, and lower initial PEEP and FiO2, but no significant differences as regard complications between the 2 groups. In conclusion: NIPPV is more effective and safer than NCPAP in the initial treatment of RDS.
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