Akbarian-Rad Zahra, Mohammadi Avishan, Khafri Soraya, Ahmadpour-Kacho Mousa, Zahed-Pasha Yadollah, Haghshenas-Mojaveri Mohsen
Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Clin Respir J. 2020 Aug;14(8):740-747. doi: 10.1111/crj.13191. Epub 2020 Jun 1.
The aim of this study was to evaluate the effect of humidified high-flow nasal cannula (HHHFNC) therapy, and compare it with the effect of nasal Continuous Positive Airway Pressure (NCPAP) in neonates with respiratory distress syndrome (RDS).
In this clinical study, consecutively admitted 27-32 weeks preterm infants with RDS who received surfactant through a brief intubation (INSURE method) were randomly assigned immediately after extubation to HHHFNC or NCPAP. Primary outcomes were oxygen saturation values and oxygen need at 6, 12 and 24 h after surfactant administration as well as duration of oxygen and respiratory support, need for intubation and mechanical ventilation and incidence of apnea. Secondary outcomes were duration of hospitalization and incidence of complications such as pneumothorax.
Sixty-four infants met the inclusion criteria and were enrolled in the study, 32 per arm. Two cases in HHFNC group dropped due to congenital pneumonia/sepsis. No differences were seen between groups in primary and secondary outcomes except for arterial oxygen saturation values (SaO2) 24 h after surfactant administration that were significantly higher in the NCPAP group [95.97% ± 1.96% vs. 95.00% ± 1.80% (P = .04)] with similar oxygen needs. The treatment failure was observed in four (11.8%) infants of the NCPAP group compared to five (16.7%) cases of the HHHFNC group (P = .57).
Based on the results of the present study, the HHHFNC can be as effective as NCPAP to treat the neonates with RDS after surfactant administration.
本研究旨在评估高流量鼻导管湿化吸氧（HHHFNC）疗法的效果，并将其与经鼻持续气道正压通气（NCPAP）治疗新生儿呼吸窘迫综合征（RDS）的效果进行比较。
在这项临床研究中，连续收治的27 - 32周患有RDS且通过简短插管接受表面活性剂治疗（INSURE方法）的早产儿在拔管后立即被随机分配至HHHFNC组或NCPAP组。主要结局指标为给予表面活性剂后6、12和24小时的血氧饱和度值和吸氧需求，以及吸氧和呼吸支持的持续时间、插管和机械通气需求及呼吸暂停发生率。次要结局指标为住院时间和并发症（如气胸）发生率。
64例婴儿符合纳入标准并纳入研究，每组32例。HHHFNC组有2例因先天性肺炎/败血症退出。除给予表面活性剂后24小时动脉血氧饱和度值（SaO2）外，两组的主要和次要结局指标均无差异，NCPAP组该指标显著更高[95.97% ± 1.96% 对 95.00% ± 1.80%（P = 0.04）]，吸氧需求相似。NCPAP组有4例（11.8%）婴儿治疗失败，HHHFNC组有5例（16.7%）（P = 0.57）。
基于本研究结果，HHHFNC在治疗接受表面活性剂治疗后的RDS新生儿方面与NCPAP同样有效。
