Department of Pediatrics, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur 795005, India.
Department of Neonatology, Bharati Vidyapeeth Deemed University Medical College, Pune, India.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa082.
The objective of this study was to compare the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) for prevention of extubation failure in preterm infants.
Preterm infants (gestation ≥28 weeks) were randomized to HHHFNC or nCPAP after extubation. Primary outcome was extubation failure within 72 h of extubation.
A total of 128 preterm infants were randomized to receive either HHHFNC (n = 63) or nCPAP (n = 65) after extubation. The primary outcome of extubation failure within 72 h after extubation was not different between the two groups (HHHFNC, 22.2% vs. nCPAP, 18.5%, risk difference of 3.7% and 95% CI -10.3 to 17.6, p = 0.604). The incidence of nasal trauma was significantly lower in the HHHFNC group than in the nCPAP group 6.3% vs. 21.5%, p = 0.020.
In our study, HHHFNC was as effective as nCPAP for prevention of extubation failure in preterm infants. Also, HHHFNC was associated with significantly less nasal trauma compared with nCPAP.
本研究旨在比较加热湿化高流量鼻导管（HHHFNC）和经鼻持续气道正压通气（nCPAP）预防早产儿拔管失败的疗效和安全性。
将早产儿（胎龄≥28 周）在拔管后随机分为 HHHFNC 或 nCPAP 组。主要结局为拔管后 72 小时内拔管失败。
共有 128 例早产儿在拔管后随机接受 HHHFNC（n=63）或 nCPAP（n=65）治疗。拔管后 72 小时内拔管失败的主要结局在两组之间无差异（HHHFNC，22.2%比 nCPAP，18.5%，风险差为 3.7%，95%CI-10.3 至 17.6，p=0.604）。HHHFNC 组的鼻腔创伤发生率明显低于 nCPAP 组（6.3%比 21.5%，p=0.020）。
在本研究中，HHHFNC 预防早产儿拔管失败的效果与 nCPAP 相当。此外，与 nCPAP 相比，HHHFNC 与明显较少的鼻腔创伤相关。
