Claris O, Salle B L, Lapillonne A, Ronin E, Picaud J C, Besnier S
Service de néonatologie, hôpital Edouard-Herriot, Lyon, France.
Arch Pediatr. 1996 May;3(5):452-6. doi: 10.1016/0929-693x(96)86403-7.
Early treatment with nasal continuous positive airway pressure (CPAP) in newborns with respiratory distress syndrome is useful, by recruiting alveoli and restoring the functional residual capacity.
Nasal CPAP was supplied by the Infant Flow Driver (Electro Medical Equipment). From 15 June 1994 to 15 December 1994, 42 neonates received nasal CPAP. Their mean birthweight and gestational age were 1511 +/- 411 g and 30.9 +/- 2.5 weeks, respectively. Fifteen infants had been ventilated for hyaline membrane disease and nasal CPAP was applied immediately after extubation. In the other 27 infants, nasal CPAP was given soon after birth (respiratory distress syndrome: 20 neonates; apneic spells: seven neonates).
Three infants needed subsequent mechanical ventilation because of the severity of the disease (one had spontaneous pneumothorax); four infants received exogenous surfactant (Curosurf, one single dose) within a brief period of mechanical ventilation (30-45 min). There were no failure of extubation, and no intracranial lesions. Excess of pharyngeal secretion and abdominal distension were common.
Early treatment with nasal CPAP reduces the need for mechanical ventilation. Furthermore, surfactant therapy required by a moderate to severe disease is possible with a rather short period of artificial ventilation.
对患有呼吸窘迫综合征的新生儿早期使用经鼻持续气道正压通气（CPAP）是有效的，它可以使肺泡复张并恢复功能残气量。
经鼻CPAP由婴儿气流驱动仪（电子医疗设备）提供。1994年6月15日至1994年12月15日期间，42例新生儿接受了经鼻CPAP治疗。他们的平均出生体重和胎龄分别为1511±411克和30.9±2.5周。15例婴儿因透明膜病接受过机械通气，拔管后立即应用经鼻CPAP。另外27例婴儿在出生后不久接受了经鼻CPAP治疗（呼吸窘迫综合征：20例新生儿；呼吸暂停发作：7例新生儿）。
3例婴儿因病情严重需要后续机械通气（1例发生自发性气胸）；4例婴儿在短暂机械通气（30 - 45分钟）期间接受了外源性表面活性物质（珂立苏，单剂量）治疗。没有拔管失败的情况，也没有颅内病变。咽部分泌物过多和腹胀很常见。
早期经鼻CPAP治疗可减少机械通气的需求。此外，对于中重度疾病所需的表面活性物质治疗，在较短时间的人工通气后是可行的。
