Guay Jennifer M, Carvi Dru, Raines Deborah A, Luce Wendy A
University at Buffalo SUNY, Email:
Neonatal Netw. 2018 Jan 1;37(1):24-32. doi: 10.1891/0730-0832.37.1.24.
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP. Effective use of nCPAP requires a coordinated interprofessional team approach, ongoing assessment of the neonate, troubleshooting the nCPAP circuit, and parent education.
呼吸窘迫仍然是新生儿发病的主要原因。目前的新生儿治疗实践建议，对于所有孕周且有呼吸窘迫临床表现的新生儿，在即刻复苏和持续支持过程中使用经鼻持续气道正压通气（nCPAP）。尽管nCPAP有诸多短期和长期益处，但许多新生儿护理单位在其常规使用方面遇到了阻力。虽然最近有大量出版物研究了各种nCPAP输送模式、表面活性剂给药、机械通气以及其他形式的无创呼吸支持（高流量鼻导管、鼻间歇正压通气）的使用和结果，但相对缺乏关于接受nCPAP治疗的婴儿床边实际护理的出版物。有效使用nCPAP需要跨专业团队的协同方法、对新生儿的持续评估、排除nCPAP回路故障以及对家长进行教育。
