Kumar R M, Kabra S K, Singh M
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
J Trop Pediatr. 1997 Feb;43(1):47-9. doi: 10.1093/tropej/43.1.47.
Eighty under-five children admitted in the pediatric ward with acute respiratory distress requiring oxygen inhalation were prospectively studied. Oxygen was administered to all the children by head box, face mask, nasopharyngeal catheter, and twin-holed prenasal catheter in a predetermined sequence. Oxygen was delivered at a flow rate of 4 l/min in the head box and by face mask and at a rate of 1 l/min for nasopharyngeal catheter and twin-holed prenasal catheter. There was a significant rise in paO2 and SaO2 values with all the oxygen delivery methods. The number of children who achieved paO2 of > 90 mmHg with oxygen delivered by head box was 53 (69 per cent), with face mask 37 (57 per cent), with nasopharyngeal catheter 13 (26 per cent), and with twin-holed prenasal catheter 18 (25 per cent). In view of high acceptability of twin-holed prenasal catheter, a further pilot study involving 10 children was carried out to compare the efficacy of head box and twin-holed prenasal catheter at an identical oxygen flow rate of 4 l/min. The number of children achieving paO2 of > 90 mmHg were comparable, i.e. seven (70 per cent) and eight (80 per cent) when the oxygen was delivered by head box and twin-holed prenasal catheter, respectively. It is concluded that both head box and twin-holed prenasal catheter are equally effective, acceptable and safe methods for administration of oxygen to children with acute respiratory disorders. In view of the cost-effectiveness, and easy availability and affordability of twin-holed prenasal catheter, it should be popularized in the small hospitals in the community, while head box should be reserved for use in the referral hospitals.
对80名入住儿科病房、因急性呼吸窘迫需要吸氧的5岁以下儿童进行了前瞻性研究。按照预定顺序，通过头罩、面罩、鼻咽导管和双孔鼻前导管对所有儿童进行吸氧。头罩和面罩吸氧时的流速为4升/分钟，鼻咽导管和双孔鼻前导管吸氧时的流速为1升/分钟。所有吸氧方式下，动脉血氧分压（PaO2）和动脉血氧饱和度（SaO2）值均显著升高。通过头罩吸氧使PaO2>90 mmHg的儿童有53名（69%），通过面罩吸氧的有37名（57%），通过鼻咽导管吸氧的有13名（26%），通过双孔鼻前导管吸氧的有18名（25%）。鉴于双孔鼻前导管的高接受度，又进行了一项涉及10名儿童的试点研究，以比较在相同氧流速4升/分钟的情况下，头罩和双孔鼻前导管的吸氧效果。通过头罩和双孔鼻前导管吸氧使PaO2>90 mmHg的儿童数量相当，分别为7名（70%）和8名（80%）。得出的结论是，头罩和双孔鼻前导管都是给急性呼吸疾病儿童吸氧的同样有效、可接受且安全的方法。鉴于双孔鼻前导管具有成本效益，且易于获取和价格低廉，应在社区小医院推广使用，而头罩则应保留给转诊医院使用。
