Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy.
Newborn Services, John Radcliffe Hospital, Oxford, UK.
Acta Paediatr. 2019 May;108(5):865-869. doi: 10.1111/apa.14611. Epub 2018 Nov 13.
This study compared how non-invasive respiratory support (NRS) was provided in neonatal units in Italy and the UK.
An NRS questionnaire was sent to tertiary neonatal centres, identified by national societies, from November 2015 to May 2016.
Responses were received from 49/57 (86%) UK units and 103/115 (90%) Italian units. NRS was started in the delivery room by 61% of UK units and 85% of Italian units. In neonatal intensive care units, 33% of UK units used nasal high-flow therapy (HFT) as primary support, compared to 3% in Italy. Nasal continuous positive airway pressure (CPAP) was used in 57% of UK units and 90% of Italian units. The commonest starting flow rate on nasal HFT for term and preterm infants was 6 L/min in the UK, while Italian units mainly used this flow for term infants. In the UK, 67% of units decreased nasal HFT by 1 L/min per day. In Italy, infants on nasal CPAP were weaned by 1 cm H O per day in 39% of units.
The way that NRS was managed for very preterm infants differed between the UK and Italy, reflecting a lack of evidence on optimal NRS and the use of local protocols.
本研究比较了意大利和英国的新生儿单位提供非侵入性呼吸支持（NRS）的方式。
2015 年 11 月至 2016 年 5 月，通过国家学会确定了三级新生儿中心，并向其发送了一份 NRS 调查问卷。
收到了 49/57（86%）个英国单位和 103/115（90%）个意大利单位的回复。61%的英国单位和 85%的意大利单位在产房开始使用 NRS。在新生儿重症监护病房，33%的英国单位使用鼻高流量治疗（HFT）作为主要支持，而意大利只有 3%。57%的英国单位和 90%的意大利单位使用鼻持续气道正压通气（CPAP）。在英国，足月和早产儿使用的鼻 HFT 起始流量通常为 6L/min，而意大利的单位主要将这种流量用于足月婴儿。在英国，67%的单位每天减少 1L/min 的鼻 HFT。在意大利，39%的单位中，使用鼻 CPAP 的婴儿每天减少 1cmH2O。
英国和意大利在管理极早产儿的 NRS 方式上存在差异，这反映了缺乏关于最佳 NRS 和使用本地方案的证据。
