Renesme Laurent, Dumas de la Roque Eric, Germain Christine, Chevrier Agnès, Rebola Muriel, Cramaregeas Sophie, Benard Antoine, Elleau Christophe, Tandonnet Olivier
Neonatal Intensive Care Unit, University Hospital of Bordeaux, Bordeaux, France.
Pôle de Santé Publique, Clinical Epidemiology Unit, University Hospital of Bordeaux, Bordeaux, France.
Pediatr Pulmonol. 2020 Oct;55(10):2617-2623. doi: 10.1002/ppul.24935. Epub 2020 Jul 10.
To determine if nasal high-frequency percussive ventilation (nHFPV) to manage neonatal respiratory distress decreases the regional cerebral oxygen saturation (rScO ) compared to nasal continous positive airway pressure (nCPAP).
A prospective, randomized, monocentric, open-label, noninferiority crossover trial. Newborns of gestational age (GA) ≥ 33 weeks exhibiting persistent respiratory distress after 10 minutes of life were treated with nHFPV and nCPAP, in succession and in random order. The primary endpoint was the mean rScO , as revealed by near-infrared spectroscopy (NIRS).
Forty-nine newborns were randomized; the mean GA and birth weight was 36.4 ± 1.9 weeks and 2718 ± 497 g. The mean rScO difference during the last 5 minutes of each ventilation mode (nHFPV minus nCPAP) was -0.7 ± 5.4% (95% confidence interval (CI) -2.25; 0.95%).
In our study on newborns of GA ≥33 weeks treated for respiratory distress, cerebral oxygenation via nHFPV was not inferior to nCPAP.
确定与经鼻持续气道正压通气（nCPAP）相比，采用经鼻高频振荡通气（nHFPV）治疗新生儿呼吸窘迫是否会降低局部脑氧饱和度（rScO₂）。
一项前瞻性、随机、单中心、开放标签、非劣效性交叉试验。对胎龄（GA）≥33周、出生后10分钟仍有持续性呼吸窘迫的新生儿，依次随机采用nHFPV和nCPAP进行治疗。主要终点是近红外光谱（NIRS）显示的平均rScO₂。
49例新生儿被随机分组；平均GA和出生体重分别为36.4±1.9周和2718±497g。每种通气模式最后5分钟期间的平均rScO₂差值（nHFPV减去nCPAP）为-0.7±5.4%（95%置信区间（CI）-2.25；0.95%）。
在我们对GA≥33周、因呼吸窘迫接受治疗的新生儿的研究中，nHFPV对脑氧合的效果不劣于nCPAP。
