Kadivar Maliheh, Mosayebi Ziba, Razi Nosrat, Nariman Shahin, Sangsari Razieh
Department of Neonatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Med Sci. 2016 Nov;41(6):494-500.
In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation).
A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in this study. Using a randomized sequence, they were assigned into two groups after INSURE method. The first group received HFNC while the second group received NCPAP for respiratory support after extubation. A comparison was made between these two groups by the rate of reintubation, air leak syndrome, duration of oxygen therapy, hospitalization, the rate of bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and mortality. Data were analyzed by using the SPSS version 18 software. The statistical analyses included Student's t-test for continuous data and compared proportions using Chi-squared test and Fisher's exact test for categorical data.
The rate of reintubation was higher in the HFNC compared with the NCPAP group. The rate of either IVH or ROP had no significant differences between the two groups. In addition, duration of oxygen requirement and hospitalization were not statistically different. There was no case of BPD or mortality among these patients.
This study showed that preterm infants with RDS could manage post-extubation after INSURE method with either NCPAP or HFNC. However, in this single-center study, the rate of reintubation was higher in the HFNC group while further multicenter study might be assigned. IRCT201201228800N1.
近年来,新生儿中越来越多地采用各种无创呼吸支持(NRS)通气方式。本研究的目的是比较高频鼻导管吸氧(HFNC)与鼻塞持续气道正压通气(NCPAP)对采用INSURE方法(插管、使用表面活性剂、拔管)治疗的呼吸窘迫综合征(RDS)早产儿拔管后的效果。
本研究共纳入54例RDS早产儿。采用随机序列,在INSURE方法后将他们分为两组。第一组在拔管后接受HFNC,第二组接受NCPAP进行呼吸支持。比较两组的再插管率、气胸综合征发生率、氧疗持续时间、住院时间、支气管肺发育不良(BPD)发生率、脑室内出血(IVH)发生率、早产儿视网膜病变(ROP)发生率及死亡率。使用SPSS 18.0软件进行数据分析。统计分析包括对连续数据采用Student t检验,对分类数据采用卡方检验和Fisher精确检验比较比例。
与NCPAP组相比,HFNC组的再插管率更高。两组间IVH或ROP的发生率无显著差异。此外,氧疗需求持续时间和住院时间在统计学上无差异。这些患者中无BPD或死亡病例。
本研究表明,RDS早产儿在INSURE方法后拔管可采用NCPAP或HFNC。然而,在这项单中心研究中,HFNC组的再插管率更高,可能需要进一步开展多中心研究。IRCT201201228800N1。