Noninvasive Respiratory Support Strategies for Transient Tachypnea of the Newborn: Impact of Nasal CPAP and Bi-level CPAP on Clinical Outcomes.

BACKGROUND: Bi-level nasal continuous positive airway pressure (CPAP) has gained wide acceptance as an alternative to nasal CPAP (NCPAP) in preterm infants with respiratory distress. However, data regarding its use in term and late preterm infants with transient tachypnea of the newborn (TTN) remain limited. PURPOSE: To compare the effectiveness and short-term clinical outcomes of NCPAP and bi-level CPAP in late preterm and term infants with TTN. METHODS: In this retrospective study, 402 infants with a gestational age of 34-42 weeks were included. Infants receiving NCPAP constituted group 1 (n = 162), whereas those supported with bi-level CPAP constituted group 2 (n = 240). Demographic and clinical data were collected and analyzed statistically. RESULTS: The duration of noninvasive mechanical ventilation was significantly shorter in the bi-level CPAP group compared with the CPAP group (P < .001). The mean length of hospital stay was also shorter among infants receiving bi-level CPAP than among those receiving NCPAP (3.88 ± 2.39 vs. 6.54 ± 5.56 days; P < .001). Rates of intubation and pneumothorax were similar between the 2 groups. IMPLICATIONS FOR PRACTICE AND RESEARCH: Both NCPAP and bi-level CPAP seem to be safe and effective in late preterm and term infants with TTN. Bi-level CPAP may shorten the duration of respiratory support and hospital stay, potentially supporting more efficient nursing care, earlier family involvement, and a smoother transition to routine neonatal care. Further prospective studies are needed to confirm these findings and to explore their implications for nursing practice.