评估三种无创通气模式在治疗早产儿严重呼吸窘迫综合征拔管后的效果。
Evaluation of three non-invasive ventilation modes after extubation in the treatment of preterm infants with severe respiratory distress syndrome.
机构信息
Department of Pediatrics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Department of Ultrasound, The First Hospital of Nanchang, Nanchang, Jiangxi Province, China.
出版信息
J Perinatol. 2022 Sep;42(9):1238-1243. doi: 10.1038/s41372-022-01461-y. Epub 2022 Aug 11.
OBJECTIVE
To evaluate the efficacy and safety of three different modes of non-invasive post-extubation ventilation support in preterm infants with severe respiratory distress syndrome (RDS).
METHODS
Infants diagnosed with severe RDS after extubation were randomized to receive nasal continuous positive airway pressure ventilation (NCPAP), nasal intermittent positive pressure ventilation (NIPPV), and non-invasive high-frequency oscillatory ventilation (NHFO). The clinical outcomes and complications of infants in different groups were recorded.
RESULTS
In infants less than 32 weeks, NCPAP had a significant increase in extubation failure when compared with NIPPV and NHFO, and the gastrointestinal feeding time, the numbers of apnea, and hospitalization costs in the NCPAP group were significantly higher. The incidence of complications was also higher in the NCPAP group. There was no difference in clinical outcomes and complications in infants greater than 32 weeks.
CONCLUSION
For infants with severe RDS less than 32 weeks after extubation, NIPPV and NHFO are more cost-effective in comparison to NCPAP.
目的
评估三种不同的经鼻间歇正压通气（NIPPV）、经鼻持续气道正压通气（NCPAP）和高频振荡通气（NHFO）在治疗拔管后严重呼吸窘迫综合征（RDS）早产儿中的疗效和安全性。
方法
将拔管后诊断为严重 RDS 的婴儿随机分为三组，分别接受 NCPAP、NIPPV 和 NHFO 治疗。记录不同组婴儿的临床结局和并发症。
结果
在小于 32 周的婴儿中，与 NIPPV 和 NHFO 相比，NCPAP 组的拔管失败率显著增加，且 NCPAP 组的胃肠喂养时间、呼吸暂停次数和住院费用均显著增加，并发症发生率也更高。在大于 32 周的婴儿中，三组的临床结局和并发症无差异。
结论
对于拔管后 32 周内患有严重 RDS 的婴儿，NIPPV 和 NHFO 比 NCPAP 更具成本效益。
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