Pedersen Majken Bisgaard, Vahlkvist Signe
Pediatric Department, Hospital of South West Jutland, Finsensgade 35, 6700 Esbjerg, Denmark.
Children (Basel). 2017 Apr 20;4(4):28. doi: 10.3390/children4040028.
Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced We conducted a retrospective study of treatment with CPAP vs. HFNC between 2013 and 2015, comparing the development in respiratory rate, fraction of inspired oxygen (FiO2) and heart rate, treatment failure, duration of treatment, and length of hospital stay. A sample size of 49 children were included. Median age was 1.9 months. Median baseline pCO₂ was 7.4 kPa in both groups, respiratory rate per minute was 57 vs. 58 (CPAP vs. HFNC). Respiratory rate decreased faster in the CPAP group ( < 0.05). FiO2 decreased in the CPAP group and increased in the HFNC group during the first 12 h, whereafter it decreased in both groups. ( < 0.01). Heart rate development was similar in both groups. Twelve children (55%) changed systems from HFNC to CPAP due to disease progression. There was no difference in length of treatment, hospital stay, or transmission to intensive care unit between the groups. CPAP was more effective than HFNC in decreasing respiratory rate (RR) and FiO2. No differences were observed in length of treatment or complications. Further studies should be conducted to compare the efficacy of the two treatments of bronchiolitis, preferably through prospective randomized trials.
持续气道正压通气（CPAP）已在患细支气管炎的婴儿中使用了数十年。最近，高流量鼻导管（HFNC）疗法被引入。我们对2013年至2015年间使用CPAP与HFNC治疗进行了一项回顾性研究，比较呼吸频率、吸入氧分数（FiO2）和心率的变化、治疗失败情况、治疗持续时间和住院时间。纳入了49名儿童样本。中位年龄为1.9个月。两组的中位基线pCO₂均为7.4 kPa，每分钟呼吸频率分别为57次和58次（CPAP组对HFNC组）。CPAP组呼吸频率下降更快（<0.05）。在最初12小时内，CPAP组的FiO2下降，HFNC组的FiO2上升，此后两组均下降（<0.01）。两组的心率变化相似。12名儿童（55%）因病情进展从HFNC转换为CPAP治疗。两组在治疗持续时间、住院时间或转入重症监护病房方面无差异。CPAP在降低呼吸频率（RR）和FiO2方面比HFNC更有效。在治疗持续时间或并发症方面未观察到差异。应进行进一步研究以比较两种细支气管炎治疗方法的疗效，最好通过前瞻性随机试验进行。
