Rastogi Shantanu, Rajasekhar Hariprem, Gupta Anju, Bhutada Alok, Rastogi Deepa, Wung Jen-Tien
Division of Neonatology, Maimonides Infants Children Hospital of Brooklyn, 1048 Tenth Avenue, G-103, Brooklyn, NY 11203, USA.
Int J Pediatr. 2012;2012:416073. doi: 10.1155/2012/416073. Epub 2011 Dec 8.
Objective. Identification of the weight and postmenstrual age (PMA) at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean. Study Design. Retrospective review of 454 neonates ≤32 weeks of gestational age (GA) who were placed on NCPAP and successfully weaned to room air was performed. Results. Neonates had a mean birth weight (BW) of 1357 ± 392 grams with a mean GA of 29.3 ± 2.2 weeks. Neonates were weaned off NCPAP at mean weight of 1611 ± 432 grams and mean PMA of 32.9 ± 2.4 weeks. Univariate analysis showed that chorioamnionitis, intubation, surfactant use, PDA, sepsis/NEC, anemia, apnea, GER and IVH were significantly associated with the time to NCPAP wean. On multivariate analysis, among neonates that were intubated, BW was the only significant factor (P < 0.001) that was inversely related to time to successful NCPAP wean. Amongst non-intubated neonates, along with BW (P < 0.01), chorioamnionitis (P < 0.01), anemia (P < 0.0001), and GER (P < 0.02) played a significant role in weaning from NCPAP. Conclusion. Neonates were weaned off NCPAP at mean weight of 1611 ± 432 grams and mean PMA of 32.9 ± 2.4 weeks. BW significantly affects weaning among intubated and non-intubated neonates, though in neonates who were never intubated chorioamnionitis, anemia and GER also significantly affected the duration on NCPAP.
目的。确定早产新生儿无创持续气道正压通气（NCPAP）成功撤机时的体重及孕龄（PMA），并分析影响成功撤机的因素。研究设计。对454例胎龄≤32周且接受NCPAP治疗并成功撤机至空气呼吸的新生儿进行回顾性研究。结果。新生儿平均出生体重（BW）为1357±392克，平均胎龄为29.3±2.2周。新生儿NCPAP撤机时的平均体重为1611±432克，平均孕龄为32.9±2.4周。单因素分析显示，绒毛膜羊膜炎、插管、使用表面活性剂、动脉导管未闭、败血症/坏死性小肠结肠炎、贫血、呼吸暂停、胃食管反流（GER）和脑室内出血与NCPAP撤机时间显著相关。多因素分析显示，在插管的新生儿中，BW是与NCPAP成功撤机时间呈负相关的唯一显著因素（P<0.001）。在未插管的新生儿中，除BW（P<0.01）外，绒毛膜羊膜炎（P<0.01）、贫血（P<0.0001）和GER（P<0.02）在NCPAP撤机中起重要作用。结论。新生儿NCPAP撤机时的平均体重为1611±432克，平均孕龄为32.9±2.4周。BW对插管和未插管的新生儿撤机均有显著影响，不过在从未插管的新生儿中，绒毛膜羊膜炎、贫血和GER也显著影响NCPAP使用时间。
