Badiee Zohreh, Eshghi Alireza, Mohammadizadeh Majid
Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Child Growth and Development Center, Isfahan, Iran.
Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2015 Apr 10;6:33. doi: 10.4103/2008-7802.154922. eCollection 2015.
To compare two methods of weaning premature infants from nasal continuous positive airway pressure (NCPAP).
Between March and November 2012, 88 preterm infants who were stable on NCPAP of 5 cmH2O with FIO2 <30% for a minimum of 6 h were randomly allocated to one of two groups. The high flow nasal cannula (HFNC) group received HFNC with flow of 2 L/min and FIO2 = 0.3 and then stepwise reduction of FIO2 and then flow. The non-HFNC group was maintained on NCPAP of 5 cmH2O and gradual reduction of oxygen until they were on FIO2 = 0.21 for 6 h, and we had weaned them directly from NCPAP (with pressure of 5 cmH2O) to room air.
No significant differences were found between 2 study groups with regards to gestational age, birth weight, Apgar score at 1 and 5 min after birth, patent ductus arteriosus and use of xanthines. The mean duration of oxygen therapy after randomization was significantly lower in HFNC group compared to non-HFNC group (20.6 ± 16.8 h vs. 49.6 ± 25.3 h, P < 0.001). Also, the mean length of hospital stay was significantly lower in HFNC group compared to non-HFNC group (11.3 ± 7.8 days vs. 14.8 ± 8.6 days, P = 0.04). The rate of successful weaning was not statistically different between two groups.
Weaning from NCPAP to HFNC could decrease the duration of oxygen therapy and length of hospitalization in preterm infants.
比较两种使早产儿从鼻持续气道正压通气（NCPAP）撤机的方法。
在2012年3月至11月期间，88例使用5 cmH₂O的NCPAP且吸入氧分数（FIO₂）<30%至少6小时病情稳定的早产儿被随机分为两组。高流量鼻导管（HFNC）组接受流量为2 L/min、FIO₂ = 0.3的HFNC，然后逐步降低FIO₂，再降低流量。非HFNC组维持5 cmH₂O的NCPAP并逐渐降低氧浓度，直至FIO₂ = 0.21达6小时，然后直接从NCPAP（压力为5 cmH₂O）撤至空气。
两组在胎龄、出生体重、出生后1分钟和5分钟的阿氏评分、动脉导管未闭及黄嘌呤类药物使用方面无显著差异。随机分组后，HFNC组的平均氧疗时间显著低于非HFNC组（20.6 ± 16.8小时 vs. 49.6 ± 25.3小时，P < 0.001）。此外，HFNC组的平均住院时间也显著低于非HFNC组（11.3 ± 7.8天 vs. 14.8 ± 8.6天，P = 0.04）。两组的成功撤机率无统计学差异。
从NCPAP撤至HFNC可缩短早产儿的氧疗时间和住院时间。
