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一家三级医院新生儿重症监护病房中使用气泡式持续气道正压通气治疗的新生儿呼吸窘迫的结局

Outcome of Respiratory Distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital.

作者信息

Manandhar Sunil Raja

机构信息

Department of Pediatrics, Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2019 Mar-Apr;57(216):92-97. doi: 10.31729/jnma.4294.

Abstract

INTRODUCTION

Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure.

METHODS

This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 - March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version.

RESULTS

Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of 38% to 62% whereas 24 (39%) babies required mechanical ventilation and other modalities.

CONCLUSIONS

This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

摘要

引言

呼吸窘迫是新生儿重症监护病房收治的新生儿中最常见的问题之一。肺透明膜病、胎粪吸入综合征、败血症、先天性肺炎、新生儿短暂性呼吸急促是新生儿呼吸窘迫的主要原因。气泡持续气道正压通气是一种给予自主呼吸新生儿的无创呼吸支持,用于在呼气时维持肺容量。本研究的主要目的是观察接受气泡持续气道正压通气的新生儿呼吸窘迫的结局。

方法

这是一项在加德满都医学院教学医院进行的描述性横断面研究,为期六个月(2018年10月至2019年3月)。纳入所有患有呼吸窘迫的早产儿、足月儿和过期产儿。获得了加德满都医学院机构审查委员会的伦理批准,并使用SPSS 19版本进行统计分析。

结果

本研究纳入了63例呼吸窘迫的婴儿,其中男性占45例(71%)。接受气泡持续气道正压通气的婴儿平均出生体重为2661.75±84克,胎龄为36.67±3.4周。气泡持续气道正压通气在出生后8.05±2小时开始,缓解呼吸窘迫所需的气泡持续气道正压通气持续时间为95.71±3小时。在63例婴儿中,接受气泡持续气道正压通气的新生儿呼吸窘迫改善的有39例(61%),置信区间为38%至62%,而24例(39%)婴儿需要机械通气和其他治疗方式。

结论

本研究得出气泡持续气道正压通气对患有呼吸窘迫的新生儿有用的结论。

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Respiratory distress in the newborn.新生儿呼吸窘迫
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Respiratory distress of the term newborn infant.足月新生儿呼吸窘迫。
Paediatr Respir Rev. 2013 Mar;14(1):29-36; quiz 36-7. doi: 10.1016/j.prrv.2012.02.002. Epub 2012 Mar 2.
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Respiratory morbidity in late preterm births.晚期早产儿的呼吸系统并发症。
JAMA. 2010 Jul 28;304(4):419-25. doi: 10.1001/jama.2010.1015.

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