de Ridder Rosemarie, Katz Trixie Andrea, van Kaam Anton H, Mugie Suzanne M, Weber Elske H, de Groof Femke, Kunst Annemieke, van den Heuvel Maria E N, Counsilman Clare E, Rijpert Maarten, Schiering Irene A, Wilms Janneke, Visser Fenna, Aarnoudse-Moens Cornelieke S H, Leemhuis Aleid G, Onland Wes
Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands,
Amsterdam Reproduction & Development, Amsterdam, The Netherlands,
Neonatology. 2025 Jun 21:1-9. doi: 10.1159/000546969.
The objective of this study was to determine the impact of nasal high flow (nHF) implementation on lung growth at 6 months corrected age (CA) in preterm infants.
This single-center retrospective cohort study included preterm infants born <30 weeks' gestation and surviving to 6 months CA at the neonatal intensive care unit of the Amsterdam University Medical Centers. In the nCPAP cohort (2009-2012), continuous distending pressure (CDP) was applied solely with nasal continuous positive airway pressure support. In the nHF cohort (2015-2018), nCPAP was used and followed by nHF therapy to deliver CDP. Bodyweight and length at 6 months CA were used as a proxy for lung growth. We also assessed the impact on respiratory management and neonatal morbidity. Multivariate analysis was performed after multiple imputation, using a linear regression adjusting for confounding variables.
Of the 598 eligible infants, 313 infants were included in the nCPAP cohort and 285 infants in the nHF cohort. The analyses showed no differences between the nCPAP and nHF cohort in body weight (7.29 vs. 7.31 kilogram, 95% CI -0.14 to 0.20, p = 0.71) and length (66.6 vs. 66.8 centimeters, 95% CI -0.30 to 0.81, p = 0.26) at 6 months CA. No differences in moderate/severe bronchopulmonary dysplasia (BPD) were reported, but nHF implementation was associated with longer CDP duration, a trend toward more days on supplemental oxygen, and a shift from moderate to severe BPD.
Implementation of nHF did not impact body growth, which is associated with lung growth, at 6 months CA in preterm infants born <30 weeks.
本研究的目的是确定在矫正年龄（CA）6个月时，实施经鼻高流量通气（nHF）对早产儿肺生长的影响。
这项单中心回顾性队列研究纳入了在阿姆斯特丹大学医学中心新生儿重症监护病房出生时孕周小于30周且存活至矫正年龄6个月的早产儿。在经鼻持续气道正压通气（nCPAP）队列（2009 - 2012年）中，仅通过鼻持续气道正压通气支持施加持续扩张压力（CDP）。在nHF队列（2015 - 2018年）中，先使用nCPAP，然后采用nHF治疗来施加CDP。矫正年龄6个月时的体重和身长被用作肺生长的替代指标。我们还评估了对呼吸管理和新生儿发病率的影响。在多次插补后进行多变量分析，使用线性回归对混杂变量进行调整。
在598名符合条件的婴儿中，313名婴儿被纳入nCPAP队列，285名婴儿被纳入nHF队列。分析显示，在矫正年龄6个月时，nCPAP队列和nHF队列在体重（7.29对7.31千克，95%可信区间 - 0.14至0.20，p = 0.71）和身长（66.6对66.8厘米，95%可信区间 - 0.30至0.81，p = 0.26）方面没有差异。未报告中度/重度支气管肺发育不良（BPD）存在差异，但实施nHF与更长的CDP持续时间、补充氧气天数增加的趋势以及从中度BPD向重度BPD的转变有关。
对于出生孕周小于30周的早产儿，在矫正年龄6个月时，实施nHF对与肺生长相关的身体生长没有影响。
