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Pediatrics：早产儿拔管后的吸氧方式对比

2021-09-10 从医路漫漫 MedSci原创

早产儿吸氧
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比较早产儿拔管后高流量鼻插管(HFNC)与鼻持续正压通气(NCPAP)或鼻间歇正压通气(NIPPV)的疗效和安全性。

目的:比较早产儿拔管后高流量鼻插管(HFNC)与鼻持续正压通气(NCPAP)或鼻间歇正压通气(NIPPV)的疗效和安全性。

方法:在6个三级医院的新生儿重症监护室进行前瞻性、随机、非劣效性试验。纳入34周出生、拔管后需要无创通气的婴儿。使用HFNC的婴儿分配到HFNC组，使用NCPAP或NIPPV的婴儿分配到NCPAP/NIPPV组。主要结果是拔管后7天内治疗失败。然后我们检查了HFNC治疗失败的临床方面原因。

结果:176例和196例婴儿分别被分为HFNC组和NCPAP/NIPPV组。HFNC组治疗失败率显著高于NCPAP/NIPPV组，其中54例(31%)患儿治疗失败，NCPAP/NIPPV组31例(16%)患儿治疗失败(风险差异，14.9个百分点;95%置信区间，6.2-23.2)。组织学性绒毛膜羊膜炎(P=0 .02)、经治疗的动脉导管未闭(P=0 .001)和治疗开始时的校正胎龄(P= 0.007)是HFNC治疗失败的独立危险因素。

表 拔管后HFNC治疗失败的相关因素

结论:在早产儿拔管后，HFNC的治疗失败率明显高于NCPAP或NIPPV。与HFNC治疗失败相关的独立因素是:组织性绒毛膜羊膜炎、经治疗的动脉导管未闭和治疗开始时较小的校正胎龄

原文出处

 Uchiyama A,  Okazaki K,  Kondo M, Randomized Controlled Trial of High-Flow Nasal Cannula in Preterm Infants After Extubation.Pediatrics 2020 12;146(6)

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    2022-02-13 hbwxf

    #Pediatric#

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    2021-11-16 feather89

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    2022-05-25 ms9608593228839890

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    2021-09-12 steven_u4

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    2021-09-10 临床小白

    已学习

    0

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