Anvekar Ajay P, Shah Piyush S, Nathan Elizabeth A, Doherty Dorota A, Patole Sanjay K, Simmer Karen N
a Department of Neonatal Paediatrics , King Edward Memorial Hospital for Women , Perth , Australia.
b Women and Infants Research Foundation, KEM Hospital for Women , Perth , Australia.
J Matern Fetal Neonatal Med. 2019 Sep;32(17):2824-2829. doi: 10.1080/14767058.2018.1449827. Epub 2018 Mar 20.
To assess if high frequency jet ventilation (HFJV) is associated with reduced odds of death or discharge home on oxygen in preterm infants. A case control study (1 February 2010 - 1 June 2014) comparing the primary outcome as "death or discharge home on oxygen" in preterm infants who needed HFJV (Cases) versus those who did not (Controls). Controls were matched to cases (1:1) on gestation, birthweight, gender, place of birth, growth status, antenatal glucocorticoids, and dexamethasone as treatment for severe bronchopulmonary dysplasia (BPD). Logistic regression analysis was used to control for confounders. Data on all preterm infants who needed HFJV (Cases: = 50) and 50 controls during the study period were analysed. Primary outcome was more frequent in cases versus controls, but not significant after adjusting for mean airway pressure and adjuvant therapy (e.g. diuretics) [aOR: 1.46 (0.23-9.14), = .687]. Death before discharge [odds ratios (OR): 6.00 (1.34-55.2), = .013] was more frequent in cases; discharge on home oxygen [OR: 0.88 (0.27-2.76), = 1.000] was comparable between groups. Duration of oxygen [adjusted hazard ratios (aHR): 1.23 (0.69-2.17), = .475] and incidence of treatment warranting retinopathy of prematurity [aOR: 0.10 (0.01-1.96), = .127] was not significant between cases versus controls. HFJV was not associated with reduced odds of death or discharge home on oxygen in preterm infants in our study. Adequately powered randomized trials are required to assess the efficacy and safety of HFJV in preterm infants.
评估高频喷射通气（HFJV）是否与降低早产儿死亡或出院时需吸氧的几率相关。一项病例对照研究（2010年2月1日至2014年6月1日），比较了需要HFJV的早产儿（病例组）与不需要HFJV的早产儿（对照组）的主要结局“死亡或出院时需吸氧”。对照组与病例组按孕周、出生体重、性别、出生地点、生长状况、产前糖皮质激素以及作为严重支气管肺发育不良（BPD）治疗的地塞米松进行1:1匹配。采用逻辑回归分析来控制混杂因素。分析了研究期间所有需要HFJV的早产儿（病例组：n = 50）和50名对照组的数据。病例组的主要结局比对照组更频繁，但在调整平均气道压力和辅助治疗（如利尿剂）后无显著差异[aOR：1.46（0.23 - 9.14），P = 0.687]。病例组出院前死亡[比值比（OR）：6.00（1.34 - 55.2），P = 0.013]更频繁；两组出院时在家吸氧[OR：0.88（0.27 - 2.76），P = 1.000]相当。吸氧持续时间[调整后风险比（aHR）：1.23（0.69 - 2.17），P = 0.475]和需要治疗的早产儿视网膜病变发生率[aOR：0.10（0.01 - 1.96），P = 0.127]在病例组与对照组之间无显著差异。在我们的研究中，HFJV与降低早产儿死亡或出院时需吸氧的几率无关。需要进行足够样本量的随机试验来评估HFJV在早产儿中的疗效和安全性。
