Department of Neonatology, Xuzhou Children's Hospital, Xuzhou, Jiangsu, P.R. China.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(4 Suppl):114-119.
To observe the clinical effects of combined use of inhaled nitric oxide at the early stage to cure severe respiratory failure in neonates.
45 cases of neonates with severe respiratory failure, who were admitted to the neonatal intensive care unit (NICU) of XuZhou Children's Hospital from November 2014 to February 2016, were selected as objects of study, namely the iNO treatment group. On the basis of conventional treatment and mechanical ventilation, all of them were treated with the combined use of iNO at the early stage. The arterial blood gas index, respiratory function index and other indexes of those children were observed before iNO treatment and 1 h, 6 h, 12 h and 24 h post-treatment. 31 cases of newborns with severe respiratory failure admitted to the NICU of the same hospital from July 2013 to August 2014 were analyzed and selected as the control group. The cases in this group met the same criteria as those administered the iNO treatment. Comparisons were made between both groups in terms of the duration of ventilator support, complications during treatment, oxygen supply time, hospital stay and other data.
When treated after 1 h, 6 h, 12 h and 24 h, the pH value, arterial oxygen and carbon dioxide partial pressure of children in the iNO inhalation group significantly improved compared to those before treatment, and the difference was significant (p<0.05). When treated after 6, 12 and 24 h, the inspired oxygen concentration and oxygenation values of children significantly decreased compared to before treatment (p<0.05). When treated after 6, 12, and 24 h, the mean airway pressure of children was less than that before treatment and the difference was statistically significant (p<0.05). When treated after 1 h, 6, 12, 24 h, the arterial alveolar oxygen partial pressure ratio of children was greater than that before treatment and the difference was significant (p<0.05). When treated after 24 h, the pulmonary artery pressure of children significantly decreased compared to before treatment (p<0.05). Compared to the control group, the complications during the treatment, the respirator use time, oxygen supply time, length of stay and the mortality of children in the iNO treatment group were significantly decreased.
Mechanical ventilation, combined with iNO therapy, can effectively improve the respiratory function and arterial blood gas index of neonates with severe respiratory failure, improve the oxygenation, reduce complications and improve the quality of rescue, which is worthy of promotion.
观察一氧化氮吸入在早期治疗新生儿严重呼吸衰竭中的临床效果。
选取 2014 年 11 月至 2016 年 2 月徐州儿童医院新生儿重症监护病房（NICU）收治的 45 例严重呼吸衰竭新生儿患者为研究对象，即 iNO 治疗组。在常规治疗和机械通气的基础上，均采用早期联合使用 iNO 治疗。观察治疗前及治疗后 1 h、6 h、12 h、24 h 患儿的血气指标、呼吸功能等指标。同期选取我院 NICU 收治的 31 例严重呼吸衰竭新生儿患者进行回顾性分析，选择标准与 iNO 治疗组相同，设为对照组。比较两组患儿呼吸机支持时间、治疗过程中并发症、氧供时间、住院时间等数据。
治疗后 1 h、6 h、12 h、24 h，iNO 吸入组患儿 pH 值、动脉氧分压、二氧化碳分压较治疗前明显改善，差异有统计学意义（p<0.05）；治疗后 6、12、24 h，患儿吸入氧浓度、氧合指数较治疗前明显降低，差异有统计学意义（p<0.05）；治疗后 6、12、24 h，患儿平均气道压较治疗前降低，差异有统计学意义（p<0.05）；治疗后 1 h、6 h、12 h、24 h，患儿肺泡-动脉血氧分压比值较治疗前增大，差异有统计学意义（p<0.05）；治疗后 24 h，患儿肺动脉压较治疗前明显降低，差异有统计学意义（p<0.05）。与对照组相比，iNO 治疗组患儿治疗过程中并发症、呼吸机使用时间、氧供时间、住院时间及死亡率明显降低。
机械通气联合 iNO 治疗可有效改善新生儿严重呼吸衰竭的呼吸功能和血气指标，改善氧合，减少并发症，提高抢救质量，值得推广。
