Miller Tricia A, Li Jing, Riddell Stella, Barkley Steven C
Department of Pediatrics, Santa Barbara Cottage Hospital, Santa Barbara, Calif.
Pediatr Qual Saf. 2020 Apr 10;5(2):e281. doi: 10.1097/pq9.0000000000000281. eCollection 2020 Mar-Apr.
CPAP) is associated with a decreased risk for chronic lung disease (CLD) in preterm neonates. This report examined the effectiveness of adopting CPAP to reduce respiratory complications and medication usage in a community hospital NICU.
The efficacy of CPAP was assessed by retrospective examination and comparison of 45 neonates who received CPAP and 87 neonates who received conventional ventilation only. Data on medication usage were also collected and analyzed.
After introduction of the CPAP protocol, the median number of days on oxygen decreased in the CPAP group compared with the conventional ventilation only group (median = 33 days, IQR = 7.5-66 vs median = 0, IQR = 0-0; < 0.001). The exposure to conventional ventilation decreased in the CPAP group compared with the conventional ventilation only group (median = 18 days, IQR = 5-42.5 vs median = 0, IQR = 0-7; < 0.001). Postimplementation of CPAP revealed decreases in CLD from 26 (30%) in the conventional ventilation only group to 2 (4%) in the CPAP group ( = 0.002); there was also a significant decrease in the use of sedative medications in the CPAP group compared with the conventional ventilation only group (mean = 5.20 doses, SD = 31.97 vs mean = 1.43, SD = 9.98; .001).
The use of CPAP results in significant decreases in the use of conventional ventilation, the risk for CLD, and the need for sedative medication.
持续气道正压通气（CPAP）与降低早产儿慢性肺病（CLD）的风险相关。本报告探讨了在一家社区医院新生儿重症监护病房（NICU）采用CPAP减少呼吸并发症和药物使用的有效性。
通过回顾性检查和比较45例接受CPAP的新生儿和87例仅接受传统通气的新生儿，评估CPAP的疗效。还收集并分析了药物使用数据。
引入CPAP方案后，与仅接受传统通气的组相比，CPAP组的中位吸氧天数减少（中位数 = 33天，四分位间距 = 7.5 - 66天，而中位数 = 0天，四分位间距 = 0 - 0天；P < 0.001）。与仅接受传统通气的组相比，CPAP组接受传统通气的时间减少（中位数 = 18天，四分位间距 = 5 - 42.5天，而中位数 = 0天，四分位间距 = 0 - 7天；P < 0.001）。实施CPAP后，CLD的发生率从仅接受传统通气组的26例（30%）降至CPAP组的2例（4%）（P = 0.002）；与仅接受传统通气的组相比，CPAP组镇静药物的使用也显著减少（均值 = 5.20剂，标准差 = 31.97，而均值 = 1.43，标准差 = 9.98；P = 0.001）。
使用CPAP可显著减少传统通气的使用、CLD的风险以及镇静药物的需求。
