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不同高流量设备在新生儿护理中的效果比较。

Comparison of the effectiveness of different high-flow devices in neonatal care.

机构信息

Hospital de Clínicas de Porto Alegre, Department of Physiotherapy, Neonatology Service, Porto Alegre, RS, Brazil.

Hospital de Clínicas de Porto Alegre, Department of Physiotherapy, Neonatology Service, Porto Alegre, RS, Brazil.

出版信息

J Pediatr (Rio J). 2024 Mar-Apr;100(2):212-217. doi: 10.1016/j.jped.2023.10.006. Epub 2023 Nov 27.

Abstract

OBJECTIVE

To evaluate the success rate of high-flow nasal cannula (HFNC) therapy using an adapted obsolete mechanical ventilator (MV), Optiflow™ and Vapotherm™ in newborns (NBs).

METHOD

This was a retrospective observational study conducted in the neonatal intensive care unit (NICU). The sample comprised NBs who underwent HFNC therapy due to ventilatory dysfunction, for weaning from non-invasive ventilation (NIV), or post-extubation. The three groups, stratified according to gestational age (GA) and birth weight, and corrected GA and weight at the beginning of HFNC use, were as follows: Optiflow ™, Vapotherm ™, and obsolete Mechanical Ventilator (MV) adapted for high flow therapy. Subsequently, the NBs were divided into a success group (SG) and a failure group (FG). HFNC success was defined as a therapy duration exceeding 72 h.

RESULTS

A total of 209 NBs were evaluated, with 31.1 % using HFNC due to ventilatory dysfunction, 2.4 % after extubation, and 66.5 % after NIV weaning. HFNC success rate was observed in 90.9 % of the NBs, with no difference between equipment types (Vapotherm ™, Optiflow ™, and adapted VM).

CONCLUSION

Different types of HFNC equipment are equally effective when used in neonatology for respiratory dysfunction, as a method of weaning from NIV and post-extubation. Adapted obsolete MV can be an alternative for HFCN therapy in resource-constrained settings.

摘要

目的

评估使用改良的废弃机械呼吸机(MV)、Optiflow™ 和 Vapotherm™ 对新生儿(NB)进行高流量鼻导管(HFNC)治疗的成功率。

方法

这是一项在新生儿重症监护病房(NICU)进行的回顾性观察性研究。样本包括因呼吸功能障碍而接受 HFNC 治疗、从无创通气(NIV)中脱机或拔管后进行 HFNC 治疗的 NB。根据胎龄(GA)和出生体重,以及开始 HFNC 治疗时的校正 GA 和体重,将这三组分为 Optiflow ™、Vapotherm ™ 和为高流量治疗而改良的废弃机械呼吸机(MV)。随后,NB 被分为成功组(SG)和失败组(FG)。HFNC 成功定义为治疗时间超过 72 小时。

结果

共评估了 209 例 NB,其中 31.1%因呼吸功能障碍而使用 HFNC,2.4%在拔管后,66.5%在 NIV 脱机后。90.9%的 NB 观察到 HFNC 治疗成功,不同设备类型之间无差异(Vapotherm ™、Optiflow ™ 和改良的 VM)。

结论

在新生儿呼吸功能障碍、作为从 NIV 脱机和拔管后的方法时,不同类型的 HFNC 设备在新生儿科使用时同样有效。在资源有限的情况下,改良的废弃 MV 可作为 HFNC 治疗的替代方法。

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