Long Chen, Li Wang, Wanwei Li, Jie Li, Yuan Shi
Department of Pediatrics, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing 400042, China.
Department of Blood Transfusion, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing 400042, China.
Can Respir J. 2016;2016:9092871. doi: 10.1155/2016/9092871. Epub 2016 Nov 22.
To assess whether noninvasive ventilation with Heliox reduces the need for endotracheal ventilation and subsequent complications in preterm infants with respiratory distress syndrome (RDS). A search of major electronic databases, including MEDLINE and the Cochrane Central Register of Controlled Trials, for randomized or quasi-randomized controlled trials that compared noninvasive ventilation with Heliox versus noninvasive ventilation with standard gas for preterm infants with RDS was performed. The primary outcome was the incidence of intubation. The secondary outcomes were the level of PaCO, the use of surfactant, and other complications. Two randomized and one quasi-randomized controlled trials including 123 preterm infants were assessed. Heliox was found to significantly decrease the incidence of intubation (RR: 0.42; 95% CI: 0.23 to 0.78), the level of PaCO (MD: -9.61; 95% CI: -15.76 to -03.45), and the use of surfactant (RR: 0.25; 95% CI: 0.10 to 0.61) as compared with standard gas. No significant differences were found in other secondary outcomes. Noninvasive ventilation with Heliox decreases the incidence of intubation in preterm infants suffering from RDS. However, data on clinical outcomes are limited. Larger trials are needed to verify the beneficial effects.
评估氦氧混合气无创通气是否能减少呼吸窘迫综合征（RDS）早产儿气管插管通气的需求及后续并发症。检索包括MEDLINE和Cochrane对照试验中央注册库在内的主要电子数据库，以查找比较氦氧混合气无创通气与标准气体无创通气用于RDS早产儿的随机或半随机对照试验。主要结局是插管发生率。次要结局是动脉血二氧化碳分压（PaCO）水平、表面活性剂的使用及其他并发症。评估了两项随机和一项半随机对照试验，共纳入123例早产儿。结果发现，与标准气体相比，氦氧混合气能显著降低插管发生率（相对危险度：0.42；95%可信区间：0.23至0.78）、PaCO水平（平均差值：-9.61；95%可信区间：-15.76至-3.45）以及表面活性剂的使用（相对危险度：0.25；95%可信区间：0.10至0.61）。在其他次要结局方面未发现显著差异。氦氧混合气无创通气可降低RDS早产儿的插管发生率。然而，关于临床结局的数据有限。需要更大规模的试验来验证其有益效果。
