鼻高频振荡通风和新生儿抽气后同步鼻间歇性正压通风之间的二氧化碳水平:一个交叉随机对照试验
Kulthida Baingam1, Manapat Phatigomet1, Anucha Thatrimontrichai1
1Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
American journal of perinatology
|June 20, 2023
概括
同步鼻间歇性正压通风 (sNIPPV) 显示,新生儿的二氧化碳 (pCO2) 部分压力比鼻高频振荡通风 (nHFOV) 低. 这一发现在所有新生儿中是一致的,包括早产和非常早产的婴儿.
科学领域:
- 新生儿呼吸辅助器的使用方法
- 机械通风策略 机械通风策略
- 新生儿心肺生理学 新生儿心肺生理学
背景情况:
- 鼻高频振荡通风 (nHFOV) 和同步鼻间歇性正压通风 (sNIPPV) 用于产后的新生儿呼吸支.
- 这两种方法都旨在降低二氧化碳 (pCO2) 的部分压力,而与鼻子连续正气道压力相比.
- 在控制pCO2水平方面,nHFOV和sNIPPV的比较有效性需要进一步澄清.
研究的目的:
- 为了比较nHFOV和sNIPPV在降低新生儿pCO2水平的有效性.
- 为了确定哪种通风模式,nHFOV或sNIPPV,对于输出管后的pCO2管理更优越.
- 调查早产和非常早产新生儿之间的潜在疗效差异.
主要方法:
- 一项交叉随机研究,涉及102名带有动脉线的被直管的早产和满期新生儿.
- 参与者被随机分配到nHFOV,然后是sNIPPV或sNIPPV,然后是nHFOV序列.
- 在每种通风模式的2小时后测量pCO2水平,对早产和非常早产婴儿进行亚组分析.
主要成果:
- 与nHFOV (38.7 ± 8.8 mm Hg) 相比,sNIPPV (36.8 ± 10.2 mm Hg) 的平均pCO2水平明显较低.
- 对于pCO2的平均差异为1.9mm Hg,有利于sNIPPV (p=0.007).
- 在早产和非常早产子组的通风模式之间没有发现pCO2水平的统计学上显著差异.
结论:
- 同步鼻间歇性正压通风 (sNIPPV) 与鼻高频振荡通风 (nHFOV) 相比,与抽出术后的pCO2水平较低有关.
- 建议在新生儿呼吸管理中提供全方位的非侵入性通风支持.
- 该研究没有发现早产或非常早产新生儿的nHFOV和sNIPPV之间的pCO2水平有显著差异.
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