PDF(1117 KB)
Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants
WANG Zhu, XIANG Jian-Wen, GAO Wei-Wei, SHEN Yong-Zhen, ZHOU Wen-Ji, CHEN Jia, XU Fang, YANG Jie
Chinese Journal of Contemporary Pediatrics ›› 2018, Vol. 20 ›› Issue (8) : 603-607.
PDF(1117 KB)
PDF(1117 KB)
Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants
Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among very low birth weight (VLBW) preterm infants.Methods A total of 89 very low birth weight premature infants with respiratory distress syndrome (RDS) who were randomly administered with NIPPV (n=46) and HHHFNC (n=43) as an initial respiratory support. The incidence of initial treatment failure, the usage of pulmonary surfactant (PS), the parameters of respiratory support treatment and the incidence of complications were compared between the two groups.Results There were no significant differences between the NIPPV and HHHFNC groups in the following items:the rate of intubation within 72 hours, rate of PS use, duration of invasive or non-invasive mechanical ventilation, duration of oxygen therapy, and incidence rates of severe apnea and pneumonia (P > 0.05). There were also no significant differences in the incidence rates of bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, intracranial hemorrhage, and air leak between the two group (P > 0.05). The incidence rate of nose injury in the NIPPV group was higher than that in the HHHFNC group (P < 0.05).Conclusions As an initial respiratory support for very low birth weight preterm infants with RDS, HHHFNC has a similar clinical effect as NIPPV, suggesting that HHHFNC is a safe and effective clinical option as a non-invasive ventilation treatment.
Respiratory distress syndrome / Intermittent positive pressure ventilation / High flow nasal cannula / Very low birth weight infant
[1] 王陈红, 施丽萍, 马晓路, 等. 无创高频振荡通气模式在极低出生体重儿呼吸支持中的应用[J]. 中华儿科杂志, 2017, 55(3):177-181.
[2] 周建国, 陈超. 无创通气技术在新生儿呼吸疾病中的应用[J].中华围产医学杂志, 2017, 20(1):65-68.
[3] Lemyre B, Laughon M, Bose C, et al. Eearly nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants[J]. Cochrane Database Syst Rev, 2016, 12:CD005384.
[4] 陈佳, 高薇薇, 许芳, 等. 两种辅助通气方式治疗极低出生体重儿呼吸窘迫综合征临床疗效分析[J].中国当代儿科杂志, 2017, 17(8):847-851.
[5] Lemyre B, Davis PG, De Paoli AG, et al. Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for preterm neonates after extubation[J]. Cochrane Database Syst Rev, 2014, 3(9):CD003212.
[6] Wilkinson D, Andersen C, O'Donnell CPF, et al. High flow nasal cannula for respiratory support in preterm infants[J].Cochrane Database Syst Rev, 2016, 66(5):CD006405.
[7] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第4版. 北京:人民卫生出版社, 2011:396, 413, 417, 434, 479, 534, 707, 889.
[8] Kugelman A, Riskin A, Said W, et al. A randomized pilot study comparing heated humidified high-flow nasal cannulae with NIPPV for RDS[J]. Pediatr Pulmonol, 2015, 50(6):576-583.
[9] 陈佳, 高薇薇, 聂川, 等. 经鼻间歇与鼻塞式持续正压通气治疗早产低出生体重儿呼吸窘迫综合征[J]. 中华围产医学杂志, 2015, 18(2):111-116.
[10] 高薇薇, 柳国胜, 许芳, 等. 极低出生体质量早产儿生后早期鼻塞式间歇与持续正压通气的比较[J]. 中山大学学报(医学科学版), 2015, 36(2):231-236.
[11] 张华岩. 早产儿肺损伤的预防及新生儿呼吸支持的研究进展[J].发育医学电子杂志, 2017, 5(4):220-223.
[12] 中国医师协会新生儿科医师分会. 早产儿呼吸窘迫综合征早期防治专家共识[J].发育医学电子杂志, 2017, 5(3):129-131.
[13] Ramanathan R, Sekar KC, Rasmussen M, et al. Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress syndrome in preterm infants<30 weeks' gestation:a randomized, controlled trial[J]. J Perinatol, 2012, 32(5):336-343.
[14] Kahramaner Z, Erdemir A, Turkoglu E. Unsynchronized nasal intermittent positive pressure versus nasal continuous positive airway pressure in preterm infants after extubation[J]. J Matern Fetal Neonatal Med, 2014, 27(9):926-929.
[15] Sai Sunil Kishore M, Dutta S, Kumar P. Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome[J]. Acta Paediatrica, 2009, 98(9):1412-1415.
[16] Meneses J, Bhandari V, Alves JG. Nasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome:a systematic review and meta-analysis[J]. Arch Pediatr Adolesc Med, 2012, 166(4):372-376.
[17] 陈佳, 高薇薇, 许芳, 等. 不同辅助通气方式预防超低出生体重早产儿拔管失败的临床研究[J]. 中国新生儿科杂志, 2016, 31(2):86-90.
[18] Saslow JG, Aghai ZH, Nakhla TA, et al. Work of breathing using high-flow nasal cannula in preterm infants[J]. J Perinatol, 2006, 26(8):476-480.
[19] Jeon GW. Respiratory support with heated humidified high flow nasal cannula in preterm infants[J]. Korean J Pediatr, 2016, 59(10):389-394.
[20] Calum T, Roberts MB, Ch B, et al. Nasal high-flow therapy for primary respiratory support in preterm infants[J]. N Engl J Med, 2016, 375(12):1142-1151.
[21] Kong X, Xu F, Wu R, et al. Neonatal mortality and morbidity among infants between 24 to 31 complete weeks:a multicenter survey in China from 2013 to 2014[J]. BMC Pediatr, 2016, 16(1):174.
