非侵入性间歇性正压通风与非侵入性高频振荡式通风作为极高出生体重婴儿的输出管后支持:一项回顾性研究
Wanjun Wang1,2,3, Rong Tan4, Wenbin Dong5,6,7
1Southwest Medical University, Luzhou, Sichuan, China.
European journal of pediatrics
|April 21, 2025
概括
非侵入性高频振荡通风 (NHFOV) 显示出比非侵入性间歇性正压通风 (NIPPV) 在预防极低出生体重婴儿脱口术后治疗失败方面更好的疗效. 这两种方法都显示出类似的安全性.
科学领域:
- 新生儿科学 新生儿科学
- 儿科呼吸系统医学 儿科呼吸系统医学
- 关键的护理关键的护理
背景情况:
- 已知非侵入性间歇性正压通风 (NIPPV) 与鼻腔连续正气道压力 (NCPAP) 相比,可以降低输出失败率,但不会显著影响支气管肺功能失调 (BPD).
- 目前存在有限的证据来比较非侵入性高频振荡通风 (NHFOV) 和NIPPV在早产婴儿的输出管后呼吸支持方面的疗效.
- 在极低出生体重 (ELBW) 婴儿中,NHFOV显示出减少输出失败的潜力,NHFOV和NIPPV都表现出可比的安全性.
研究的目的:
- 为了比较NHFOV与NIPPV的疗效和安全性,作为ELBW婴儿初始输出口后的非侵入性呼吸辅助.
- 评估接受NHFOV或NIPPV的婴儿在输出管后7天内治疗失败率.
主要方法:
- 进行了一项单一中心的回顾性研究.
- 包括175名ELBW婴儿 (平均出生体重972±145g,妊娠年龄27.3±1.6周) 接受他们的第一次输出管.
- 婴儿接受了NIPPV或NHFOV作为输出管后呼吸辅助.
主要成果:
- 在输出管后7天内治疗失败发生在NIPPV组 (22/82) 的婴儿中有26.8%的婴儿,而NHFOV组 (13/93) 的婴儿中有14.0%.
- 治疗失败的风险差异有利于NHFOV (12.8个百分点;95% CI,0.1到25.7;p=0.03).
- 在NIPPV和NHFOV组之间,在7天内重新灌输率没有显著差异.
结论:
- 与NIPPV相比,NHFOV显著降低了 ELBW 婴儿的治疗失败率,这些婴儿需要排气后的呼吸支持.
- 与NIPPV相比,NHFOV提供了一个更有效的非侵入性呼吸支策略,与NIPPV相比,与NIPPV相比,与NIPBW婴儿脱口后的非侵入性呼吸支策略相比,具有类似的安全性.
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