经鼻间歇正压通气与持续气道正压通气即刻应用于早产儿出生后的随机对照试验。
NIV-NAVA versus NCPAP immediately after birth in premature infants: A randomized controlled trial.
机构信息
Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.
Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.
出版信息
Respir Physiol Neurobiol. 2022 Aug;302:103916. doi: 10.1016/j.resp.2022.103916. Epub 2022 Apr 29.
OBJECTIVE
To evaluate whether noninvasive-neurally adjusted ventilatory assist (NIV-NAVA) decrease respiratory efforts compared to nasal continuous positive airway pressure (NCPAP) during the first hours of life.
METHODS
Twenty infants born between 28 and 31 weeks were randomized to NIV-NAVA or NCPAP. Positive end-expiratory pressure was constantly kept at 6 cmHO for both groups and the NAVA level was 1.0 cmHO/µV for NIV-NAVA group. The electrical activity of diaphragm (Edi) were recorded for the first two hours.
RESULTS
Peak and minimum Edi decreased similarly in both groups (P = 0.98 and P = 0.59, respectively). Leakages were higher in the NIV-NAVA group than in the NCPAP group (P < 0.001). The neural apnea defined as a flat Edi for ≥ 5 s were less frequent in NIV-NAVA group than in NCPAP group (P = 0.046).
CONCLUSIONS
Immediately applied NIV-NAVA in premature infants did not reduce breathing effort, measured as peak Edi. However, NIV-NAVA decreased neural apneic episodes compared to NCPAP.
目的
评估在生命最初数小时内，与经鼻持续气道正压通气（NCPAP）相比，无创神经调节通气辅助（NIV-NAVA）是否可减少呼吸努力。
方法
将 20 名胎龄为 28 至 31 周的婴儿随机分为 NIV-NAVA 组或 NCPAP 组。两组均将呼气末正压保持在 6cmH2O，NIV-NAVA 组的 NAVA 水平为 1.0cmH2O/µV。在最初的 2 小时内记录膈肌电活动（Edi）。
结果
两组的峰 Edi 和最小 Edi 均相似下降（P=0.98 和 P=0.59）。NIV-NAVA 组的漏气量高于 NCPAP 组（P<0.001）。与 NCPAP 组相比，NIV-NAVA 组的神经暂停（定义为 Edi 平坦≥5s）更为少见（P=0.046）。
结论
立即应用于早产儿的 NIV-NAVA 并未降低呼吸努力，以峰 Edi 衡量。然而，与 NCPAP 相比，NIV-NAVA 减少了神经暂停发作。
Zotero 插件