Abstract: Abstract：Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation combined with nasal continuous positive airway pressure (NIPPV+NCPAP) and nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome. Methods A total of 102 newborns with respiratory distress syndrome (RDS) who were admitted between January 2018 to June 2019 were randomly divided into two groups NIPPV+ NCPAP group (n=50) and NCPAP group (n=52). The differences in the improving respiratory rate, oxygen and reduce lactic acid value, ventilation failure, related complications were compared in newborns with RDS between NIPPV+NCPAP group and NCPAP group. According to the ventilation outcome, all the newborns were divided into failed ventilation group (n=34) and successful ventilation group (n=68). The effects of inhaled oxygen volume fraction (FiO2) and lactic acid on the outcome of ventilation were analyzed in the two groups. Results The reducing breath rate, increasing oxygen partial pressure and improving oxygen at 1 h, 6 h, and 12 h were significantly better in NIPPV+NCPAP group than those of NCPAP group (all P＜ 0.05). The lactic acid value decreased with ventilation time in NIPPV+NCPAP group. After ventilation for 12 h, the lactate value was significantly lower in NIPPV + NCPAP group than that of NCPAP group (P＜0.05). The ventilation failure and apnea also reduced in NIPPV+NCPAP group than those of NCPAP group (all P＜0.05). There were no significant differences  in non-invasive ventilation time, no oxygenation time after non-invasive surgery, total intestinal feeding time, hospitalization
time, hospitalization expenses, and complications such as chlorination of chloral hydrate due to irritability, feeding
intolerance, necrotizing enterocolitis, sepsis, patent ductus arteriosus, intracranial hemorrhage, and bronchopulmonary
dysplasia between the two groups of newborns (all P＞0.05). Compared with the successful ventilation group, the FiO2 ≥ 0.30
within 2 hours after birth and lactic acid value continued to increase obviously more in the ventilation failure group (all P＜
0.05). Conclusion The noninvasive ventilation strategy with NIPPV combined with NCPAP is safe for neonatal respiratory
distress syndrome, which is effective and worth promoting.  

Key words: respiratory distress syndrome, newborn, intermittent positive-pressure ventilation, continuous positive airway pressure, lactic acid