Neonatal Intensive Care Unit; Kovai Medical Center and Hospital (KMCH), Coimbatore, India.
KMCH Research Foundation, Coimbatore, India.
J Neonatal Perinatal Med. 2024;17(5):647-651. doi: 10.3233/NPM-230192.
There is no objective criteria to wean CPAP in preterm neonates. We aimed to assess the accuracy of 'saturation trends' to predict successful CPAP discontinuation.
We included very preterm neonates who required CPAP. Index tests were 'saturation trends'. Outcome was successful CPAP discontinuation, defined as baby stable in room air for 72 h.
We had 120 neonates with mean±SD gestation 28.6±1.8 weeks. 96 (80%) neonates had successful discontinuation and 24 (20%) failed. Neonates with successful discontinuation had significantly greater 'saturation trends' during 24 h before discontinuing CPAP compared to those who failed [64.3 (48.1-83.7) vs. 47.3 (23.0-65.0), p = 0.001]. Saturations > 95% while on CPAP with 21% FiO2 for > 60% time had 63% sensitivity and 70% specificity to predict successful CPAP discontinuation.
'Saturation trends' is a readily available objective parameter that can be used to guide weaning CPAP in preterm neonates.
目前尚无客观标准来指导早产儿撤离 CPAP。本研究旨在评估“饱和度趋势”预测 CPAP 成功撤离的准确性。
我们纳入了需要 CPAP 治疗的极早产儿。本研究的检测指标为“饱和度趋势”，主要结局为 CPAP 成功撤离，定义为患儿在空气环境中稳定 72 h。
本研究共纳入 120 例胎龄为 28.6±1.8 周的早产儿，其中 96 例（80%）患儿成功撤离 CPAP，24 例（20%）患儿撤离 CPAP 失败。与撤离 CPAP 失败的患儿相比，成功撤离 CPAP 的患儿在停止 CPAP 治疗前 24 h 的“饱和度趋势”显著更高[64.3（48.1-83.7）比 47.3（23.0-65.0），p=0.001]。当 FiO2 为 21%时，CPAP 下饱和度>95%且持续时间>60%的患儿，其 CPAP 成功撤离的敏感度为 63%，特异度为 70%。
“饱和度趋势”是一种易于获得的客观参数，可用于指导早产儿撤离 CPAP。
