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使用实时呼吸做功指数调整呼吸功能不全早产儿高流量鼻导管的流速。

Adjustment of high flow nasal cannula rates using real-time work of breathing indices in premature infants with respiratory insufficiency.

机构信息

Department of Neonatology, ChristianaCare, Newark, DE, United States.

Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.

出版信息

J Perinatol. 2021 Jul;41(7):1711-1717. doi: 10.1038/s41372-021-00977-z. Epub 2021 Mar 4.

DOI:10.1038/s41372-021-00977-z
PMID:33664469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8867510/
Abstract

OBJECTIVE

To assess the feasibility of real-time monitoring of work of breathing (WOB) indices and the impact of adjusting HFNC flow on breathing synchrony and oxygen stability in premature infants.

STUDY DESIGN

A prospective, observational study of infants stable on HFNC. The flow adjusted per predetermined algorithm. Respiratory inductive plethysmography (RIP) noninvasively measured WOB. A high-resolution pulse oximeter collected oxygen saturation and heart rate data. Summary statistics and mixed linear models were used.

RESULTS

Baseline data for 32 infants, final analysis of 21 infants. Eighty-one percent with abnormal WOB. Sixty-two percent demonstrated 20% improvement in WOB. For infants with gestational age <28 weeks, an incremental increase in HFNC flow rate decreased WOB (p < 0.001) and improved oxygen saturation and stability (p < 0.01).

CONCLUSIONS

Premature infants do not receive optimal support on HFNC. The use of a real-time feedback system to adjust HFNC is feasible and improves WOB, oxygen saturation, and oxygen stability. This technology may improve the utility of HFNC in premature infants.

摘要

目的

评估实时监测呼吸功（WOB）指标的可行性，以及调整高流量鼻导管（HFNC）流量对早产儿呼吸同步性和氧稳定性的影响。

研究设计

一项针对 HFNC 稳定的早产儿的前瞻性观察研究。按照预定算法调整流量。呼吸感应体容积描记术（RIP）无创测量 WOB。高分辨率脉搏血氧仪采集氧饱和度和心率数据。使用汇总统计和混合线性模型。

结果

32 名婴儿的基线数据，21 名婴儿的最终分析。81%的婴儿存在异常 WOB。62%的婴儿 WOB 改善了 20%。对于胎龄<28 周的婴儿，HFNC 流速的增量增加降低了 WOB（p<0.001），并改善了氧饱和度和稳定性（p<0.01）。

结论

早产儿在 HFNC 上未得到最佳支持。使用实时反馈系统来调整 HFNC 是可行的，可以改善 WOB、氧饱和度和氧稳定性。这项技术可能会提高 HFNC 在早产儿中的应用效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/3db42629011d/nihms-1778428-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/8bd7bb7c3cb7/nihms-1778428-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/10624e5fbff3/nihms-1778428-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/3db42629011d/nihms-1778428-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/8bd7bb7c3cb7/nihms-1778428-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/10624e5fbff3/nihms-1778428-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec18/8867510/3db42629011d/nihms-1778428-f0003.jpg

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