Narendran Vivek, Donovan Edward F, Hoath Steven B, Akinbi Henry T, Steichen Jean J, Jobe Alan H
Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45267-0541, USA.
J Perinatol. 2003 Apr-May;23(3):195-9. doi: 10.1038/sj.jp.7210904.
To test whether the introduction of early bubble continuous positive airway pressure (CPAP) results in improved respiratory outcomes in extremely low birth-weight infants.
Outcomes of all infants between 401 and 1000 g born in a level 3 neonatal intensive care units (NICU) between July 2000 and October 2001 (period 2) were compared using historical controls (period 1). Early bubble (CPAP) was prospectively introduced in the NICU during period 1. Univariate and adjusted comparisons were made across time periods.
Delivery room intubations, days on mechanical ventilation and use of postnatal steroids decreased (p<0.001) in period 2, while mean days on CPAP, number of babies on CPAP at 24 hours (p<0.001) and mean weight at 36 weeks corrected gestation also increased (p<0.05) after introduction of early bubble CPAP.
Early bubble CPAP reduced delivery room intubations, days on mechanical ventilation, postnatal steroid use and was associated with increased postnatal weight gain with no increased complications.
测试早期气泡持续气道正压通气（CPAP）的引入是否能改善极低出生体重儿的呼吸结局。
采用历史对照（第1阶段），比较2000年7月至2001年10月（第2阶段）在一家三级新生儿重症监护病房（NICU）出生的所有401至1000克婴儿的结局。在第1阶段前瞻性地在NICU引入早期气泡（CPAP）。对不同时间段进行单变量和校正比较。
在第2阶段，产房插管、机械通气天数和产后类固醇的使用减少（p<0.001），而引入早期气泡CPAP后，平均CPAP天数、24小时时使用CPAP的婴儿数量（p<0.001）以及36周矫正胎龄时的平均体重也增加（p<0.05）。
早期气泡CPAP减少了产房插管、机械通气天数、产后类固醇的使用，并且与出生后体重增加有关，且并发症未增加。
