Nasef Nehad, Rashed Hend Me, Aly Hany
Neonatal Intensive Care Unit, Mansora University Children's Hospital, Mansoura, Egypt.
Department of Pediatrics, Faculty of Medicine, University of Mansoura, Egypt.
Int J Pediatr Adolesc Med. 2020 Mar;7(1):19-25. doi: 10.1016/j.ijpam.2020.02.005. Epub 2020 Feb 18.
Preterm infants frequently present with respiratory insufficiency requiring respiratory assistance. Invasive mechanical ventilation has been associated with several short and long term complications. Therefore, the practice of early use of non-invasive ventilation has been adopted. Nasal CPAP proved efficacy as an initial therapy for preterm infants. Non-invasive positive pressure ventilation is an alternative used to mitigate CPAP failure in infants with apnea or increased work of breathing. High flow nasal cannula gained popularity primarily due to the ease of its use, despite multiple prominent trials that demonstrated its inferiority. Bi-level positive airway pressure and neurally adjusted non-invasive ventilatory are used in infants with apnea and increased work of breathing. The effectiveness of non invasive ventilation tools can be augmented by having a proper protocol for initiation, weaning, skin care, positioning, and developmental care during their application.
早产儿经常出现呼吸功能不全，需要呼吸支持。有创机械通气与多种短期和长期并发症相关。因此，已采用早期使用无创通气的做法。经鼻持续气道正压通气（Nasal CPAP）已被证明是早产儿初始治疗的有效方法。无创正压通气是用于缓解呼吸暂停或呼吸做功增加的婴儿中CPAP失败的一种替代方法。高流量鼻导管主要因其使用方便而受到欢迎，尽管多项重要试验表明其效果较差。双水平气道正压通气和神经调节无创通气用于呼吸暂停和呼吸做功增加的婴儿。通过在应用无创通气工具期间制定关于启动、撤机、皮肤护理、体位摆放和发育护理的适当方案，可以提高其有效性。
