持续气道正压通气与鼻塞吸氧对晚期早产儿和足月儿新生儿暂时性呼吸急促的影响。
Effect of continuous positive airway pressure versus nasal cannula on late preterm and term infants with transient tachypnea of the newborn.
机构信息
Department of Women and Infants, Baylor Scott & White Medical Center, McKinney, TX, USA.
Pediatrix Medical Group of Dallas, Dallas, TX, USA.
出版信息
J Perinatol. 2021 Jul;41(7):1675-1680. doi: 10.1038/s41372-021-01068-9. Epub 2021 May 13.
OBJECTIVE
To compare continuous positive airway pressure (CPAP) with nasal cannula (NC) as primary noninvasive respiratory therapy in hypoxic infants for transient tachypnea of the newborn (TTN).
STUDY DESIGN
Retrospective cohort study of infants born at ≥34 weeks of gestation between January 1, 2015 and December 31, 2018.
RESULT
After adjusting for gestational age and birth weight, the maximum fractional inspired oxygen (FiO) was significantly lower in the CPAP group with an incidence rate ratio (IRR) of 0.85 (95% CI: 0.76-0.96). Although nonsignificant, the CPAP group needed 32% fewer hours on oxygen with an IRR of 0.68 (95% CI: 0.38-1.22). The duration of respiratory support and the incidence of pneumothorax were similar between both groups.
CONCLUSION
Comparing CPAP with NC as initial noninvasive respiratory therapy for TTN, significantly lower maximum FiO was observed in the infants of CPAP group without increase in the incidence of pneumothorax.
目的
比较持续气道正压通气（CPAP）与鼻塞（NC）作为新生儿短暂性呼吸急促（TTN）的一线无创呼吸治疗方法。
研究设计
对 2015 年 1 月 1 日至 2018 年 12 月 31 日期间出生胎龄≥34 周的婴儿进行回顾性队列研究。
结果
调整胎龄和出生体重后，CPAP 组的最大吸入氧分数（FiO）显著降低，发生率比（IRR）为 0.85（95%可信区间：0.76-0.96）。虽然没有统计学意义，但 CPAP 组需要的氧气治疗时间减少了 32%，IRR 为 0.68（95%可信区间：0.38-1.22）。两组的呼吸支持时间和气胸发生率相似。
结论
与 NC 相比，CPAP 作为 TTN 的初始无创呼吸治疗方法，CPAP 组婴儿的最大 FiO 显著降低，气胸发生率无增加。
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