在早产婴儿的非侵入性呼吸辅助过程中,优化气体温度和相对湿度的控制:一种简单而低成本的干预措施
Karina Segatto1, Renata Monteiro Weigert2, Mariane Ferreira da Silveira1
1Neonatal Division, Tacchini Hospital, Bento Goncalves, Brazil.
一项用于控制呼吸气体温度和相对湿度 (T&RH) 的低成本政策显著减少了早产婴儿的鼻血. 这种干预措施在没有先进设备的低中等收入国家 (LMIC) 改善了临床结果.
科学领域:
- 新生儿护理 新生儿护理
- 呼吸辅助系统 呼吸辅助系统
- 医疗器械工程 医疗器械工程
背景情况:
- 在非侵入性呼吸辅助过程中输送高流量气体需要精确的温度和相对湿度 (T&RH) 控制,以防止上呼吸道并发症.
- 在低中等收入国家 (LMIC) 中,先进的闭环T&RH控制系统往往无法使用.
- 为了解决这些系统局限性,实施了密切的T&RH控制政策.
研究的目的:
- 评估新实施的气体密切控制政策T&RH对早产婴儿临床结果的影响.
- 在资源有限的环境中评估低成本的T&RH控制战略的可行性和有效性.
主要方法:
- 一个单一中心的回顾性研究包括128名早产婴儿 (2019-2020年6月).
- 干预涉及将加热器启动到更高的设置,并根据间歇性温度检查和凝结评估,每6小时调整T&RH.
- 婴儿被分为两组:接受和不接受密切的T&RH控制政策的婴儿. 主要结局是鼻出血;次要结局包括坚持,模式变化和输管.
主要成果:
- 尽管非侵入性支持的持续时间较长,但在密切控制T&RH的治疗组中,鼻出血率从30%显著降低到14% (p=0.026).
- 对T&RH控制政策的遵守率高达93%.
- 观察到需要改变原始呼吸辅助模式的显著减少 (14%与3%相比;p=0.024),没有发生内内管道输入的病例.
结论:
- 在LMIC环境中,在非侵入性呼吸辅助过程中优化气体T&RH的简单,低成本的干预措施是可行的.
- 这一政策与显著的临床改善有关,包括减少鼻血和减少呼吸辅助模式的变化.
- 这些发现支持在资源有限的环境中实施此类战略,缺乏先进的呼吸辅助技术.
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