Huang Tzyy-Rong, Chen Hsiu-Lin, Yang Shu-Ting, Su Pin-Chun, Chung Hao-Wei
Respiratory Therapy Team, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Biomedicines. 2024 Apr 10;12(4):838. doi: 10.3390/biomedicines12040838.
In recent years, the utilization of minimally invasive surfactant therapy (MIST) and Non-invasive ventilation (NIV) as the primary respiratory assistance has become increasingly prevalent among preterm infants with neonatal respiratory distress syndrome (RDS). This study aims to compare the outcomes between MIST administered with nasal continuous positive airway pressure (NCPAP) versus nasal intermittent positive pressure ventilation (NIPPV), with the objective of exploring the respiratory therapeutic benefits of these two approaches. This retrospective study collected data from the neonatal intensive care unit of Kaohsiung Medical University Hospital spanning from January 2016 to June 2021. Infants were divided into two groups based on the type of NIV utilized. The NCPAP group comprised 32 infants, while the NIPPV group comprised 22 infants. Statistical analysis revealed significant differences: the NIPPV group had a smaller gestational age, lower birth weight, higher proportion of female infants, and earlier initiation of MIST. Additionally, the NIPPV group exhibited higher incidence rates of retinopathy of prematurity, longer respiratory support duration, prolonged hospitalization, and mortality. However, upon adjustment, these differences were not statistically significant. Analysis of venous blood gas and respiratory parameter changes indicated that both the NCPAP and NIPPV groups experienced improvements in oxygenation and ventilation following MIST.
近年来,微创表面活性剂治疗(MIST)和无创通气(NIV)作为主要呼吸支持手段在患有新生儿呼吸窘迫综合征(RDS)的早产儿中越来越普遍。本研究旨在比较经鼻持续气道正压通气(NCPAP)联合MIST与经鼻间歇正压通气(NIPPV)联合MIST的治疗效果,以探讨这两种方法的呼吸治疗益处。这项回顾性研究收集了高雄医学大学附属医院新生儿重症监护病房2016年1月至2021年6月的数据。根据所使用的NIV类型将婴儿分为两组。NCPAP组有32名婴儿,而NIPPV组有22名婴儿。统计分析显示出显著差异:NIPPV组的胎龄更小、出生体重更低、女婴比例更高,且更早开始进行MIST治疗。此外,NIPPV组的早产儿视网膜病变发病率更高、呼吸支持时间更长、住院时间延长且死亡率更高。然而,经调整后,这些差异无统计学意义。静脉血气分析和呼吸参数变化表明,MIST治疗后NCPAP组和NIPPV组的氧合和通气均有所改善。