高流量鼻导管持续气道正压通气与婴儿流量法用于早产儿的比较
Nasal continuous positive airway pressure from high flow cannula versus Infant Flow for Preterm infants.
作者信息
Campbell D M, Shah P S, Shah V, Kelly E N
机构信息
Department of Paediatrics, Mt Sinai Hospital, University of Toronto, Toronto, ON, Canada.
出版信息
J Perinatol. 2006 Sep;26(9):546-9. doi: 10.1038/sj.jp.7211561. Epub 2006 Jul 13.
OBJECTIVE
To compare the feasibility of continuous positive airway pressure (CPAP) support generated by high flow nasal cannula with conventional CPAP for prevention of reintubation among preterm infants with a birth weight of <or=1,250 g.
STUDY DESIGN
Preterm infants were randomized to CPAP generated via high flow cannula or the Infant Flow Nasal CPAP System (VIASYS, Conshohocken, PA, USA) at extubation. Primary outcome was incidence of reintubation within 7 days. Secondary outcomes included change in oxygen use and frequency of apnea and bradycardias postextubation.
RESULTS
Forty neonates were randomized. Twelve of 20 infants randomized to high flow cannula CPAP were reintubated compared to three of 20 using Infant Flow (P=0.003). The high flow cannula group had increased oxygen use and more apneas and bradycardias postextubation.
CONCLUSIONS
CPAP delivered by high flow nasal cannula failed to maintain extubation status among preterm infants <or=1,250 g as effectively as Infant Flow CPAP.
目的
比较高流量鼻导管产生的持续气道正压通气（CPAP）支持与传统CPAP在预防出生体重≤1250g的早产儿再次插管方面的可行性。
研究设计
早产儿在拔管时被随机分为通过高流量导管产生的CPAP组或婴儿流量鼻CPAP系统（VIASYS，美国宾夕法尼亚州康舍霍肯）组。主要结局是7天内再次插管的发生率。次要结局包括拔管后氧气使用的变化以及呼吸暂停和心动过缓的频率。
结果
40名新生儿被随机分组。随机分配到高流量导管CPAP组的20名婴儿中有12名再次插管，而使用婴儿流量系统的20名婴儿中有3名再次插管（P = 0.003）。高流量导管组拔管后氧气使用增加，呼吸暂停和心动过缓更多。
结论
高流量鼻导管提供的CPAP在维持出生体重≤1250g的早产儿拔管状态方面不如婴儿流量CPAP有效。
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