McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.
J Perinatol. 2021 Nov;41(11):2658-2663. doi: 10.1038/s41372-021-01200-9. Epub 2021 Sep 11.
The objective of this study was to determine whether abrupt discontinuation vs gradual wean of nasal CPAP (NCPAP) in infants <30 weeks gestation results in a decreased duration of NCPAP therapy.
We performed a single-center, randomized control trial of premature infants born <30 weeks gestation (n = 66), comparing discontinuation of NCPAP from 6 cmHO (CWP) (fast wean arm) to discontinuation at 4 CWP, weaning by 1 CWP per day (slow wean arm). The primary outcome was the total number of days on NCPAP or mechanical ventilation. Secondary outcomes included wean failure, growth, length of stay, and related comorbidities.
Duration of NCPAP or mechanical ventilation was longer in the slow wean arm compared to the fast wean arm (17 vs 12 days, p = 0.03). There were no differences observed in secondary outcomes.
In weaning NCPAP, abrupt discontinuation may be associated with a shorter duration of positive pressure respiratory support compared to a gradual weaning strategy.
本研究旨在确定与逐渐撤机相比，30 周以下早产儿经鼻持续气道正压通气（NCPAP）的突然撤机是否会缩短 NCPAP 治疗时间。
我们进行了一项单中心、随机对照试验，纳入了 30 周以下出生的早产儿（n=66），比较了从 6cmH2O（CWP）（快撤机组）到 4cmH2O 撤机，每天减少 1cmH2O 的撤机方式（慢撤机组）。主要结局是 NCPAP 或机械通气的总天数。次要结局包括撤机失败、生长、住院时间和相关并发症。
与快撤机组相比，慢撤机组 NCPAP 或机械通气的持续时间更长（17 天 vs 12 天，p=0.03）。两组在次要结局方面无差异。
在撤机 NCPAP 时，与逐渐撤机策略相比，突然撤机可能与较短的正压呼吸支持时间相关。
