Say Birgul, Kanmaz Kutman Hayriye Gozde, Oguz Serife Suna, Oncel Mehmet Yekta, Arayici Sema, Canpolat Fuat Emre, Uras Nurdan, Karahan Sevilay
Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
Neonatology. 2016;109(4):258-64. doi: 10.1159/000443263. Epub 2016 Feb 10.
Nasal continuous positive airway pressure (NCPAP) is being widely used for the treatment of respiratory distress syndrome (RDS) in preterm infants. However, there are only a few studies which compare different interfaces of NCPAP delivery and their effects on respiratory outcomes.
We aimed to determine whether NCPAP applied with binasal prongs compared to that with a nasal mask (NM) reduces the rate of moderate/severe bronchopulmonary dysplasia (BPD) in preterm infants.
Infants between 26 and 32 weeks' gestation who suffered from RDS and were treated with NCPAP were assessed. Parallel randomization was performed to eligible infants to receive NCPAP either via binasal prongs or NM. Infants were intubated if they fulfilled the predefined failure criteria. Data were collected by using the intention-to-treat principle.
One hundred and sixty infants were screened and 149 were randomized. Seventy-five infants in the binasal prong (NP) group and 74 in the NM group were analyzed. Mean gestational ages were 29.3 ± 1.6 vs. 29.1 ± 2.0 weeks (p = 0.55), and birth weights were 1,225 ± 257 vs. 1,282 ± 312 g (p = 0.22) in the NP and NM groups, respectively. The frequency of NCPAP failure within 24 h of life was higher in the NP than the NM group (8 vs. 0%; p = 0.09). The median duration of NCPAP was significantly higher in the NP group [median 4 (1-5) vs. 2 (1-3) h, p < 0.01]. The rate of moderate and severe BPD was significantly lower in the NM (n = 2, 2.7%) when compared with the NP group (n = 11, 14.6%; p < 0.01). The BPD/death rates were not different between the 2 groups (NM group: n = 18 or 24.3%; NP group: n = 19 or 25.3%; p = 0.51).
The NM was successfully used for delivering NCPAP in preterm infants, and no NCPAP failure was observed within the first 24 h. These data show that applying NCPAP by NM yielded a shorter duration of NCPAP and statistically reduced the rates of moderate and severe BPD.
鼻持续气道正压通气（NCPAP）被广泛用于治疗早产儿呼吸窘迫综合征（RDS）。然而，仅有少数研究比较了不同的NCPAP输送接口及其对呼吸结局的影响。
我们旨在确定与鼻面罩（NM）相比，使用双鼻导管进行NCPAP治疗是否能降低早产儿中重度支气管肺发育不良（BPD）的发生率。
对妊娠26至32周、患有RDS且接受NCPAP治疗的婴儿进行评估。对符合条件的婴儿进行平行随机分组，分别通过双鼻导管或NM接受NCPAP治疗。若婴儿符合预定义的失败标准，则进行插管。采用意向性分析原则收集数据。
共筛查了160例婴儿，149例被随机分组。分析了双鼻导管（NP）组的75例婴儿和NM组的74例婴儿。NP组和NM组的平均胎龄分别为29.3±1.6周和29.1±2.0周（p = 0.55），出生体重分别为1225±257 g和1282±312 g（p = 0.22）。NP组出生后24小时内NCPAP失败的频率高于NM组（8%对0%；p = 0.09）。NP组NCPAP的中位持续时间显著更长[中位值4（1 - 5）小时对2（1 - 3）小时，p < 0.01]。与NP组（n = 11，14.6%）相比，NM组（n = 2，2.7%）中重度BPD的发生率显著更低（p < 0.01）。两组的BPD/死亡率无差异（NM组：n = 18或24.3%；NP组：n = 19或25.3%；p = 0.51）。
NM成功用于为早产儿输送NCPAP，且在出生后24小时内未观察到NCPAP失败。这些数据表明，通过NM应用NCPAP可缩短NCPAP的持续时间，并在统计学上降低中重度BPD的发生率。
Zotero 插件