Mukerji Amit, Singh Balpreet, Helou Salhab El, Fusch Christoph, Dunn Michael, Belik Jaques, Shah Vibhuti
Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Paediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Am J Perinatol. 2015 Feb;30(2):171-6. doi: 10.1055/s-0034-1381317. Epub 2014 Jun 10.
The aim of the article is to review the effectiveness of neonatal noninvasive high-frequency ventilation (NIHFV) in preventing endotracheal mechanical ventilation.
Retrospective case series including all 79 instances of NIHFV use at four participating centers between July 2010 and September 2012.
In 73% of cases, NIHFV was used as rescue after another noninvasive mode, and prophylactically (postextubation) in the remainder. In 58% of cases, infants transitioned to another noninvasive mode, without requiring intubation. There were significant reductions in the mean (SD) number of apneas, bradycardias, or desaturations (over 6 hours) (3.2 [0.4] vs. 1.2 [0.3]; p < 0.001), FiO2 (48 [3] vs. 40 [2]%; p < 0.001) and CO2 levels (74 [6] vs. 62 [4] mm Hg; p = 0.025] with NIHFV. No NIHFV-related complications were noted.
NIHFV is a promising NIV mode that may help prevent or delay intubation and deserves further clinical research.
本文旨在综述新生儿无创高频通气（NIHFV）在预防气管插管机械通气方面的有效性。
回顾性病例系列研究，纳入了2010年7月至2012年9月期间四个参与中心使用NIHFV的所有79例病例。
73%的病例中，NIHFV在另一种无创模式后作为抢救措施使用，其余病例为预防性使用（拔管后）。58%的病例中，婴儿转为另一种无创模式，无需插管。使用NIHFV后，平均（标准差）呼吸暂停、心动过缓或血氧饱和度下降次数（超过6小时）显著减少（3.2[0.4]对1.2[0.3]；p<0.001），FiO2（48[3]对40[2]%；p<0.001）和二氧化碳水平（74[6]对62[4]mmHg；p=0.025）。未观察到与NIHFV相关的并发症。
NIHFV是一种有前景的无创通气模式，可能有助于预防或延迟插管，值得进一步临床研究。
