Clinical research of heated humidified high-flow nasal cannula for prevention of extubation failure in preterm infants with respiratory distress syndrome
10.3760/cma.j.issn.1673-4912.2019.03.010
- VernacularTitle:加温湿化高流量鼻导管通气预防早产儿呼吸窘迫综合征拔管失败的临床研究
- Author:
Bao JIN
1
;
Jiebin WU
;
Bin ZHOU
;
Xiao LIU
;
Xiuhui MA
Author Information
1. 东南大学附属徐州医院儿童诊疗中心新生儿科 221000
- Keywords:
Heated humidified high-flow nasal cannula;
Continuous positive airway pressure;
Respiratory distress syndrome;
Clinical efficacy;
Adverse reaction;
Infant;
Premature
- From:
Chinese Pediatric Emergency Medicine
2019;26(3):206-210
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) for prevention of extubation failure in preterm infants with respiratory distress syndrome (RDS).Methods From March 2016 to December 2017,75 preterm infants (≤32 weeks gestation) with RDS who needed noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube in neonatal intensive care unit were studied.They were randomly assigned into the HHHFNC group (38 cases) and the NCPAP group (37 cases) by using a random number table.The main observation was the success rate of removal of the ventilator,duration of noninvasive ventilation time,the total oxygen inhaling time,feeding conditions and incidence of adverse events.Results The baseline demographic characteristics of the two groups were similar in terms of gestational age,birth weight,gender,incidence of cesarean delivery,premature rupture of membranes,administrations of antenatal glucocorticoid prophylaxis,Apgar scores at 1 and 5 minutes (P ＞ 0.05).No significant difference was found in the success rate of removal of the ventilator between HHHFNC group and NCPAP group(94.7 ％ vs.91.9％,P ＞ 0.05).The time of noninvasive ventilation,the total oxygen inhaling time and hospital stay in the NCPAP group were shorter than those in the HHHFNC group,but there were no significant differences between two groups (P ＞ 0.05).The occurrence of abdominal distention (10.5％ vs.27.05％),nasal trauma(5.2％ vs.21.6％),head shaping(0 vs.32.4％) were lower in HHHFNC group than those in NCPAP group (P ＜0.05).The time needed to achieve total enteral nutrition[(10.1 ± 1.2) d vs.(14.1 ± 1.6)d] and the incidence of feeding intolerance (13.1％ vs.29.7％) were reduced in HHHFNC group than those in NCPAP group (P ＜ 0.05).Conclusion As an respiratory support for the treatment of preterm infants with RDS after extubation,HHHFNC has the similar efficacy with NCPAP.However,HHHFNC has lower incidence of nasal trauma,abdominal distension and feeding intolerance,and further clinical research is needed.
