Application effect of non-invasive high-frequency oscillatory ventilation combined with minimally invasive administration of pulmonary surfactant in extremely low birth weight premature infants with respiratory distress syndrome
10.3760/cma.j.cn431274-20231018-00404
- VernacularTitle:经鼻无创高频振荡通气联合肺表面活性物质微创给药在极低出生体重早产儿呼吸窘迫综合征中的应用效果
- Author:
Bo TIAN
1
;
Dongfang ZHENG
;
Hongtao FU
;
Fang ZHANG
Author Information
1. 唐山市妇幼保健院新生儿科，唐山 063000
- Keywords:
Infant, very low birth weight;
Respiratory distress syndrome, newborn;
High-frequency ventilation;
Pulmonary surfactant
- From:
Journal of Chinese Physician
2024;26(8):1169-1173
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the therapeutic effect of nasal non-invasive high-frequency oscillatory ventilation (NHFOV) combined with minimally invasive administration of pulmonary surfactant in the treatment of respiratory distress syndrome in extremely low birth weight premature infants.Methods:A prospective study was conducted on 106 premature infants with respiratory distress syndrome and extremely low birth weight who were admitted to the Tangshan Maternal and Child Health Care Hospital from July 2021 to July 2023 and had indications for non-invasive respiratory support therapy. They were divided into two groups using a random number table method, with 53 cases in each group. The control group was treated with routine nasal continuous positive airway pressure (NCPAP) combined with minimally invasive administration of pulmonary surfactant, while the observation group was treated with NHFOV combined with minimally invasive administration of pulmonary surfactant. After 24 hours of treatment, arterial partial pressure of carbon dioxide (PaCO 2) was compared between two groups of children, and serum levels of transforming growth factor beta 1 (TGF-β1) and high mobility group protein B1 (HMGB1) were measured. The non-invasive ventilation time, total oxygen inhalation time, mechanical ventilation rate, >1 use of pulmonary surfactant, complications, and mortality rate of the patient were recorded. Results:Before treatment and at 1 and 24 hours after treatment, the PaCO 2 levels of the two groups of children gradually decreased, and the difference was statistically significant (all P<0.05); After 1 and 24 hours of treatment, the PaCO 2 levels in the observation group were lower than those in the control group (all P<0.05). The mechanical ventilation rate of the observation group was lower than that of the control group ( P<0.05); There was no statistically significant difference ( P>0.05) in the non-invasive ventilation time, total oxygen inhalation time, and usage rate of pulmonary surfactant >1 time between the two groups of children. After treatment, the serum levels of TGF-β1 and HMGB1 in both groups of children decreased compared with those before treatment (all P<0.05), and there was no statistically significant difference between the groups (all P>0.05). There was no statistically significant difference in the incidence of bronchopulmonary dysplasia, retinopathy, necrotizing enterocolitis, intraventricular hemorrhage, lung gas leakage, nasal injury, and mortality between the two groups of children (all P>0.05). Conclusions:Minimally invasive administration of NHFOV combined with pulmonary surfactant in the treatment of respiratory distress syndrome in very low birth weight premature infants is helpful to improve CO 2 retention, reduce the proportion of mechanical ventilation, and does not increase the complications and mortality related to respiratory support treatment.
