Rong Zhi-Hui, Li Wen-Bin, Liu Wei, Cai Bao-Huan, Wang Jing, Yang Min, Li Wei, Chang Li-Wen
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Paediatr Child Health. 2016 May;52(5):493-8. doi: 10.1111/jpc.13175.
To investigate whether Bi-level positive airway pressure (BiPAP), compared with nasal continuous positive airway pressure (CPAP), is a more effective therapeutic strategy in preterm infants ≤32 weeks.
All inborn infants between 26(+1) and 32(+6) weeks' gestation, admitted to the neonatal intensive care unit (NICU ) of Tongji Medical Hospital between 1 January, 2010 and 31 December, 2011 (the 2010-2011 cohort or CPAP cohort) and between 1 January, 2012 and 31 December, 2013 (the 2012-2013 cohort or BiPAP cohort), were retrospectively identified. The primary outcome was intubation in infants < 72 h of age; secondary outcomes were mortality and the incidence of bronchopulmonary dysplasia (BPD).
There were 213 in the 2010-2011 cohort and 243 infants in the 2012-2013 cohort. There were fewer infants intubated within the first 72 h of age in the 2012-2013 cohort than in the 2010-2011 cohort (15% vs. 23%, P < 0.05). Of the infants who received some form of positive airway pressure, 12/94 (13%) of infants on BiPAP versus 23/74 (31%) on CPAP were subsequently intubated (P < 0.01). There was no difference in the incidence of moderate and severe BPD between the two groups (7% vs. 8%, P=0.52).
In this retrospective cohort study, we found BiPAP, compared with CPAP, reduced the need for intubation within the first 72 h of age.
探讨双水平气道正压通气（BiPAP）与经鼻持续气道正压通气（CPAP）相比，对孕周≤32周的早产儿是否为更有效的治疗策略。
回顾性纳入2010年1月1日至2011年12月31日（2010 - 2011队列或CPAP队列）以及2012年1月1日至2013年12月31日（2012 - 2013队列或BiPAP队列）期间入住同济医院新生儿重症监护病房（NICU）的所有孕26（+1）至32（+6）周的足月儿。主要结局是年龄<72小时的婴儿插管情况；次要结局是死亡率和支气管肺发育不良（BPD）的发生率。
2010 - 2011队列中有213例婴儿，2012 - 2013队列中有243例婴儿。2012 - 2013队列中年龄<72小时内插管的婴儿比2010 - 2011队列少（15%对23%，P<0.05）。在接受某种形式气道正压通气的婴儿中，BiPAP组12/94（13%）的婴儿随后插管，而CPAP组为23/74（31%）（P<0.01）。两组中重度BPD的发生率无差异（7%对8%，P = 0.52）。
在这项回顾性队列研究中，我们发现与CPAP相比，BiPAP降低了年龄<72小时内的插管需求。
