Roy Shelden D, Alnaji Fuad, Reddy Deepti N, Barrowman Nick J, Sheffield Holden A
University of Ottawa, Ottawa, Ontario, Canada.
Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Paediatr Child Health. 2022 Jun 22;27(5):272-277. doi: 10.1093/pch/pxac020. eCollection 2022 Sep.
Since 2016, use of nasal continuous positive airway pressure (nCPAP) in Nunavut for air transport in select patients has become common practice. This study examines the outcomes of patients transferred by air from the Qikiqtaaluk Region during air transport. We examined intubation rates, adverse events during transfer, and respiratory parameters at departure and upon arrival.
This was a retrospective review from September 2016 to December 2019 including patients under 2 years of age transferred by air on nCPAP from the Qikiqtaaluk Region of Nunavut.
Data were collected for 40 transfers involving 34 unique patients. Six transfers were from remote communities in Nunavut to Iqaluit, and 33 transfers were from Iqaluit to CHEO. The primary outcome measure was whether the patient required intubation during transport, or urgent intubation upon arrival to CHEO. The median nCPAP setting during transport was 6 cm HO (5-7 cm HO) and at arrival to CHEO was 6 cm HO (6-7 cm HO). Six of the 33 (18.2%) patients required intubation during their hospital stay and five (15.2%) in a controlled ICU setting. There were no discernible adverse events that occurred during transport for 28 patients (84.5%). Four patients (12.1%) required a brief period of bag-mask ventilation and one patient had an episode of bradycardia.
nCPAP on air transport is a safe and useful method for providing ventilatory support to infants and young children with respiratory distress.
自2016年以来，努纳武特地区对部分患者采用经鼻持续气道正压通气（nCPAP）进行空中转运已成为常见做法。本研究考察了从基吉柯塔鲁克地区通过空中转运的患者的转归情况。我们研究了插管率、转运期间的不良事件以及出发时和抵达时的呼吸参数。
这是一项回顾性研究，时间跨度为2016年9月至2019年12月，纳入了在努纳武特地区基吉柯塔鲁克地区通过nCPAP进行空中转运的2岁以下患者。
收集了涉及34名不同患者的40次转运数据。6次转运是从努纳武特的偏远社区到伊卡卢伊特，33次转运是从伊卡卢伊特到渥太华东部儿童医院。主要结局指标是患者在转运期间是否需要插管，或抵达渥太华东部儿童医院后是否需要紧急插管。转运期间nCPAP的中位设置为6厘米水柱（5 - 7厘米水柱），抵达渥太华东部儿童医院时为6厘米水柱（6 - 7厘米水柱）。33名患者中有6名（18.2%）在住院期间需要插管，5名（15.2%）在可控的重症监护病房环境中需要插管。28名患者（84.5%）在转运期间未发生明显不良事件。4名患者（12.1%）需要短时间进行面罩球囊通气，1名患者出现心动过缓发作。
空中转运时使用nCPAP是为呼吸窘迫的婴幼儿提供通气支持的一种安全且有用的方法。
