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