气泡 CPAP 与有创 CPAP 治疗早产儿呼吸窘迫综合征的随机对照研究。
Bubble CPAP versus ventilator CPAP in preterm neonates with early onset respiratory distress--a randomized controlled trial.
机构信息
Division of Neonatology, Department of Pediatrics, KEM Hospital, Pune 411011, India.
出版信息
J Trop Pediatr. 2013 Apr;59(2):113-9. doi: 10.1093/tropej/fms061. Epub 2013 Jan 9.
UNLABELLED
Bubble continuous positive airway pressure (BCPAP) is a low cost nasal CPAP delivery system with potential benefits to developing nations.
OBJECTIVE
To compare the efficacy and safety of BCPAP with ventilator-derived CPAP (VCPAP) in preterm neonates with respiratory distress.
METHODS
In a randomized controlled trial, preterm neonates with Silverman-Anderson score ≥ 4 and oxygen requirement >30% within first 6 h of life were randomly allocated to BCPAP or VCPAP. Proportion of neonates with success or failure was compared.
RESULTS
In all, 47 of 57 (82.5%) neonates from BCPAP group and 36 of 57 (63.2%) neonates from the VCPAP group completed CPAP successfully (p = 0.03). Neonates who failed CPAP had higher Silverman-Anderson score (p < 0.01), lower arterial to alveolar oxygenation ratio (p < 0.05) and needed surfactant more frequently (p < 0.01).
CONCLUSION
BCPAP has higher success rate than VCPAP for managing preterm neonates with early onset respiratory distress, with comparable safety.
背景
气泡持续气道正压通气（BCPAP）是一种低成本的鼻 CPAP 输送系统，对发展中国家可能具有潜在益处。
目的
比较 BCPAP 与呼吸机衍生 CPAP（VCPAP）治疗呼吸窘迫早产儿的疗效和安全性。
方法
在一项随机对照试验中，将出生后 6 小时内 Silverman-Anderson 评分≥4 且需要氧疗≥30%的早产儿随机分配至 BCPAP 或 VCPAP 组。比较两组患儿的成功或失败比例。
结果
BCPAP 组 47 例（82.5%）和 VCPAP 组 36 例（63.2%）早产儿成功完成 CPAP（p=0.03）。CPAP 失败的患儿 Silverman-Anderson 评分更高（p<0.01），肺泡动脉氧分压差更低（p<0.05），且更常需要肺表面活性物质治疗（p<0.01）。
结论
与 VCPAP 相比，BCPAP 治疗早期起病呼吸窘迫的早产儿成功率更高，安全性相当。
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