Collins C L, Barfield C, Davis P G, Horne R S C
Mercy Hospital for Women, Melbourne, VIC, Australia.
Mercy Hospital for Women, Melbourne, VIC, Australia.
Early Hum Dev. 2015 Dec;91(12):701-4. doi: 10.1016/j.earlhumdev.2015.09.011. Epub 2015 Oct 27.
To determine whether respiratory support via heated humidified high flow nasal cannulae (HHHFNC) results in infants <32weeks gestation spending a greater proportion of time in sleep compared to those receiving nasal continuous positive airway pressure (NCPAP).
A subgroup of infants enrolled in a randomized controlled trial to compare HHHFNC or NCPAP post-extubation had sleep and wake activity measured by actigraphy for 72hours post-extubation. Activity diaries were completed contemporaneously to record episodes of infant handling. Actigraphy data were downloaded with known periods of handling excluded from the analysis.
28 infants with mean gestation of 28.3weeks (SD 2) and birth weight 1074g (SD 371) were studied. Infants receiving HHHFNC spent a lesser proportion of time in sleep 59.8% (SD 18.5) than those on NCPAP 82.2% (SD 23.8) p=0.004. Infants receiving HHHFNC had a lower sleep efficiency and higher mean activity score than those on NCPAP (p=0.003, p=0.002, respectively).
Infants receiving HHHFNC had a higher mean activity score and spent less time in sleep than those allocated NCPAP. Further study of sleep wake activity in preterm infants receiving respiratory support is required as this may impact on neurodevelopmental outcomes.
确定与接受鼻持续气道正压通气（NCPAP）的婴儿相比，经加热湿化高流量鼻导管（HHHFNC）进行呼吸支持是否能使胎龄小于32周的婴儿有更长的睡眠时间。
在一项比较拔管后使用HHHFNC或NCPAP的随机对照试验中，对一组婴儿进行研究，在拔管后72小时通过活动记录仪测量其睡眠和清醒活动。同时完成活动日记以记录婴儿护理情况。下载活动记录仪数据，并在分析中排除已知的护理时间段。
研究了28名平均胎龄为28.3周（标准差2）、出生体重为1074克（标准差371）的婴儿。接受HHHFNC的婴儿睡眠时间占比为59.8%（标准差18.5），低于接受NCPAP的婴儿，后者为82.2%（标准差23.8），p=0.004。接受HHHFNC的婴儿睡眠效率低于接受NCPAP的婴儿，平均活动得分高于后者（分别为p=0.003，p=0.002）。
与接受NCPAP的婴儿相比，接受HHHFNC的婴儿平均活动得分更高，睡眠时间更少。需要对接受呼吸支持的早产儿的睡眠-清醒活动进行进一步研究，因为这可能会影响神经发育结局。
