Unit of Neonatology, University Hospital "Policlinico - Vittorio Emanuele", Via Carlo Azeglio Ciampi, 95121 Catania, Italy.
Unit of Neonatology, University Hospital "Policlinico - Vittorio Emanuele", Via Carlo Azeglio Ciampi, 95121 Catania, Italy.
Early Hum Dev. 2020 Mar;142:104965. doi: 10.1016/j.earlhumdev.2020.104965. Epub 2020 Feb 7.
Non-invasive respiratory ventilation has greatly improved the evolution of respiratory distress in neonates, especially for preterm infants, but few studies have investigated the use of non-invasive ventilation (NIV) in term infants. It is useful for neonatologists and nurses to identify the optimal ventilation strategy in terms of effectiveness for this group of newborns. The aim of our study was to investigate what type of respiratory support between nasal Continuous Positive Airway Pressure (nCPAP) or nasal Biphasic Positive Airway Pressure (nBiPAP) is more effective in term neonates with RDS.
Our study was a retrospective observational study of 78 full term neonates who were admitted to the NICU at S. Bambino Hospital from December 2015 to December 2016 for respiratory distress at birth. All patients underwent non-invasive ventilation by nCPAP or nBiPAP were included. Oxygen saturations and vital signs were monitored continuously. We evaluated blood gas analysis parameters before treatment and after 1 h of ventilation.
During the study period, there were 78 full term newborns admitted in our NICU for neonatal distress who were treated with nCPAP ore nBIPAP ventilation. In nBiPAP patients, we noticed a statistically significant reduction in PaCO2 levels and FiO2 requirement with respect to nCPAP patients, after 1 h of ventilation with a simultaneous significant increase of pH and PaO2 levels. There was no difference in the length of NIV and hospital stay. Among nCPAP patients, two were then intubated and one developed a pneumothorax.
The results of our study showed that an early BiPAP ventilation on RDS is the more efficient NIV because it improves CO2 removal and reduces FiO2 requirement in comparison to nCPAP. Future studies can clarify if early BiPAP ventilation on RDS is the more efficient of NIV.
无创呼吸通气极大地改善了新生儿呼吸窘迫的进展，尤其是早产儿，但很少有研究调查无创通气（NIV）在足月婴儿中的应用。对于新生儿科医生和护士来说，确定这组新生儿最佳通气策略的有效性是很有用的。我们的研究目的是调查经鼻持续气道正压通气（nCPAP）或经鼻双相气道正压通气（nBiPAP）在治疗 RDS 足月新生儿方面哪种呼吸支持更有效。
这是一项回顾性观察研究，共纳入 2015 年 12 月至 2016 年 12 月期间因出生时呼吸窘迫而在 S. Bambino 医院新生儿重症监护病房（NICU）接受治疗的 78 例足月新生儿。所有患者均接受 nCPAP 或 nBiPAP 无创通气。连续监测氧饱和度和生命体征。我们评估了治疗前和通气 1 小时后的血气分析参数。
在研究期间，有 78 例足月新生儿因新生儿窘迫在我们的 NICU 接受 nCPAP 或 nBIPAP 通气治疗。在 nBiPAP 患者中，与 nCPAP 患者相比，通气 1 小时后 PaCO2 水平和 FiO2 需求显著降低，同时 pH 值和 PaO2 水平显著升高。NIV 时间和住院时间无差异。在 nCPAP 患者中，有 2 例随后插管，1 例发生气胸。
我们的研究结果表明，与 nCPAP 相比，早期 BiPAP 通气在 RDS 中是更有效的 NIV，因为它可以提高 CO2 的清除率并降低 FiO2 的需求。未来的研究可以进一步阐明 RDS 早期 BiPAP 通气是否是更有效的 NIV。
