出生体重≤1000克婴儿的早期可变流量经鼻持续气道正压通气

Early variable-flow nasal continuous positive airway pressure in infants < or =1000 grams at birth.

作者信息

Jegatheesan P, Keller R L, Hawgood S

机构信息

Department of Pediatrics, University of California San Francisco, CA 94143-0748, USA.

出版信息

J Perinatol. 2006 Mar;26(3):189-96. doi: 10.1038/sj.jp.7211454.

DOI:10.1038/sj.jp.7211454

PMID:16453007

Abstract

OBJECTIVE

To compare the incidence of chronic lung disease (CLD) in extremely low birth weight (ELBW, < or =1000 g) infants before and after the introduction of early, preferential application of nasal continuous airway pressure (NCPAP) utilizing a variable flow delivery system.

STUDY DESIGN

A retrospective cohort study of ELBW infants 2 years prior to (Pre-early NCPAP, n=96) and 2 years following (Early NCPAP, n=75) the initiation of an early NCPAP policy.

RESULTS

There were no significant changes (Pre-early NCPAP vs Early NCPAP) in the incidences of CLD (35 vs 33%, P=0.81) or CLD or death (50 vs 43%, P=0.34). Infants in the Early NCPAP group weaned off mechanical ventilation and supplemental oxygen more rapidly than infants in the Pre-early NCPAP group (hazard ratio (HR) 1.80, P=0.002 and HR 1.69, P=0.01).

CONCLUSION

A policy of early NCPAP has not decreased the incidence of CLD despite a decrease in time to successful tracheal extubation.

摘要

目的

比较在采用可变流量输送系统早期优先应用经鼻持续气道正压通气（NCPAP）前后，极低出生体重（ELBW，≤1000克）婴儿慢性肺部疾病（CLD）的发生率。

研究设计

一项回顾性队列研究，研究对象为实施早期NCPAP政策前2年（早期NCPAP前，n = 96）和后2年（早期NCPAP，n = 75）的ELBW婴儿。

结果

CLD发生率（35%对33%，P = 0.81）或CLD合并死亡发生率（50%对43%，P = 0.34）在早期NCPAP前和早期NCPAP之间无显著变化。早期NCPAP组婴儿脱机和停用补充氧气的速度比早期NCPAP前组婴儿更快（风险比[HR] 1.80，P = 0.002；HR 1.69，P = 0.01）。