Wilmshurst J M, Rahman M A, Shah V, Elton P, Long D, Martin N
Paediatric Neurology, Newcomen Centre, Guy's Hospital, London, United Kingdom.
Am J Perinatol. 1999;16(1):13-6. doi: 10.1055/s-2007-993829.
The objective of this study was to compare the safety and efficacy of the Heat Moisture Exchange (HME) device with conventional humidification in neonates. Sixty-four neonates were randomized at intubation to receive conventional humidification (CH) (n = 34) or HME, via a Neoaid device (n = 30). Groups were compared for intrinsic characteristics and outcome variables. Data were assumed nonparametric and analyzed by Mann-Whitney and Fisher's Exact test. No significant differences were found in group characteristics or outcome variables. Trends were noted for documented patent ductus arteriosus (PDA), endotracheal tube blockage, and positive endotracheal aspirate culture. Rate of pneumothorax 2/34 (CH) versus 4/30 (HME) (p = 0.4); rate of tube blockage 3/34 (CH) versus 2/30 (HME) (p = 1.0); rate of PDA 8/34 (CH) versus 14/30 (HME) (p = 0.093) and rate of endotracheal colonisation 1 7/34 (CH) versus 9/30 (HME) (p = 0.17). No significant difference was found for duration of ventilation or period in greater than 40% oxygen between the two groups. There were no significant outcome differences between CH and HME. The HME device was cost-effective and simple to use. A larger multicenter trial is warranted to confirm the efficacy of HME.
本研究的目的是比较热湿交换(HME)装置与传统湿化方法在新生儿中的安全性和有效性。64名新生儿在插管时被随机分组,分别接受传统湿化(CH)(n = 34)或通过Neoaid装置进行热湿交换(HME)(n = 30)。对两组的固有特征和结果变量进行比较。数据假定为非参数数据,并通过曼-惠特尼检验和费舍尔精确检验进行分析。在组特征或结果变量方面未发现显著差异。在记录的动脉导管未闭(PDA)、气管内导管堵塞和气管内吸出物阳性培养方面有一定趋势。气胸发生率2/34(CH组)对4/30(HME组)(p = 0.4);导管堵塞发生率3/34(CH组)对2/30(HME组)(p = 1.0);PDA发生率8/34(CH组)对14/30(HME组)(p = 0.093);气管内定植率17/34(CH组)对9/30(HME组)(p = 0.17)。两组在通气时间或吸氧浓度大于40%的时间段方面未发现显著差异。CH和HME之间在结果方面无显著差异。HME装置具有成本效益且使用简单。有必要进行更大规模的多中心试验以证实HME的有效性。