Liet Jean-Michel, Millotte Beatrice, Tucci Marisa, Laflammme Sophie, Hutchison James, Creery David, Ducruet Thierry, Lacroix Jacques
Service de Réanimation Pédiatrique, Centre Hospitalier Universitaire de Nantes, Nantes, France.
J Pediatr. 2005 Dec;147(6):812-7. doi: 10.1016/j.jpeds.2005.07.015.
To determine whether noninvasive therapy using a helium-oxygen mixture reduces the use of positive-pressure ventilation in the treatment of respiratory failure caused by severe bronchiolitis.
This was a multicenter, randomized, double-blind, placebo-controlled trial that recruited infants in 4 pediatric intensive care units (PICUs). A total of 39 nonintubated infants with severe bronchiolitis caused by respiratory syncytial virus (RSV) were randomly assigned within 8 hours of PICU admission to receive a helium-oxygen mixture (helium group) or an air-oxygen mixture (control group) through an inflatable head hood. The primary study outcome was the requirement for positive pressure mechanical ventilation. Results were compared using Fisher's exact test.
No differences were noted between the control and helium groups with respect to age (1.0 vs 1.1 months), prematurity, or family history of asthma or smoking. Positive pressure ventilation was judged necessary for 4 of the 21 (19.0%) infants in the control group and in 4 of the 18 (22.2%) in the helium group (relative risk = 1.17; 95% confidence interval = 0.34 to 4.01).
This study did not detect any differences between the patients in the helium group and the control group with respect to the rate of positive-pressure ventilation.
确定使用氦氧混合气体的无创治疗是否能减少重症细支气管炎所致呼吸衰竭治疗中对正压通气的使用。
这是一项多中心、随机、双盲、安慰剂对照试验，在4个儿科重症监护病房（PICU）招募婴儿。共39例因呼吸道合胞病毒（RSV）引起的重症细支气管炎且未插管的婴儿在入住PICU后8小时内被随机分配，通过可充气头罩接受氦氧混合气体（氦气组）或空气 - 氧气混合气体（对照组）。主要研究结局是对正压机械通气的需求。使用Fisher精确检验比较结果。
对照组和氦气组在年龄（1.0个月对1.1个月）、早产情况、哮喘家族史或吸烟家族史方面未发现差异。对照组21例婴儿中有4例（19.0%）被判定需要正压通气，氦气组18例婴儿中有4例（22.2%）需要正压通气（相对危险度 = 1.17；95%置信区间 = 0.34至4.01）。
本研究未发现氦气组患者与对照组在正压通气率方面存在任何差异。
