Ding Fei, Zhang Jingling, Zhang Wenya, Zhao Qian, Cheng Zimei, Wang Yang, Bo Tao, Wu Hui
Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha, China.
Front Pediatr. 2020 Feb 25;8:63. doi: 10.3389/fped.2020.00063. eCollection 2020.
This study aimed to investigate the clinical efficacy and safety of different non-invasive respiratory support methods in preterm infants with respiratory distress syndrome (RDS) after extubation. From Oct 2017 to 2018, 120 preterm infants were recruited from the NICUs of three hospitals. They were diagnosed with RDS and required mechanical ventilation. After extubation from mechanical ventilation, these infants were divided into NCPAP group, SNIPPV group and SNIPPV + NCPAP group. The time of non-invasive ventilation, reintubation rate within 72 h, success rate of non-invasive ventilation within 1 week, duration of oxygen therapy, hospital stay and incidence of complications were recorded and compared. Compared with the NCPAP group, the SNIPPV group and the SNIPPV + NCPAP group had significantly higher rate of successful extubation and removal from non-invasive ventilation within 1 week ( < 0.05). There were no significant differences among three groups in the time of non-invasive ventilation, time of oxygen therapy, hospital stay or incidence of complications ( > 0.05). SNIPPV + NCPAP after mechanical ventilation is a relatively safe and effective ventilation strategy for preterm infants with severe RDS. The use of NCPAP facilitates the turnover of SNIPPV ventilators in developing countries.
本研究旨在探讨不同无创呼吸支持方法对拔管后呼吸窘迫综合征（RDS）早产儿的临床疗效及安全性。2017年10月至2018年，从三家医院的新生儿重症监护病房招募了120例早产儿。他们被诊断为RDS且需要机械通气。机械通气拔管后，这些婴儿被分为鼻塞持续气道正压通气（NCPAP）组、同步鼻间歇正压通气（SNIPPV）组和SNIPPV+NCPAP组。记录并比较无创通气时间、72小时内再插管率、1周内无创通气成功率、氧疗时间、住院时间及并发症发生率。与NCPAP组相比，SNIPPV组和SNIPPV+NCPAP组1周内成功拔管及脱离无创通气的比例显著更高（<0.05）。三组在无创通气时间、氧疗时间、住院时间或并发症发生率方面无显著差异（>0.05）。机械通气后采用SNIPPV+NCPAP对重度RDS早产儿是一种相对安全有效的通气策略。在发展中国家，使用NCPAP有助于SNIPPV呼吸机的周转。
