Analysis of effect and safety of vibrating mesh atomization inhalation of PS combined with NCPAP on neonatal respiratory distress syndrome
10.3760/cma.j.cn101721-20250103-00006
- VernacularTitle:振动网格雾化吸入PS联合NCPAP治疗NRDS的效果及安全性分析
- Author:
Zhibo GAO
1
;
Ye LI
;
Yushen LIU
Author Information
1. 空军军医大学第二附属医院儿科，西安 710038
- Publication Type:Journal Article
- Keywords:
Neonatal respiratory distress syndrome;
Vibrating mesh atomization inhalation;
Pulmonary surfactant;
Nasal continuous positive airway pressure ventilatio
- From:
Clinical Medicine of China
2025;41(5):321-328
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect and safety of vibrating mesh atomization inhalation of pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome (NRDS).Methods:150 Children with NRDS in department of pediatrics of the Second Affiliated Hospital of Air Force Medical University from May 2021 to May 2024 were enrolled as study subjects for a prospective cohort study. According to the propensity score matching, children who adopted traditional intratracheal infusion of PS combined with NCPAP were selected as infusion group (75 cases), and children who received vibrating mesh atomization inhalation of PS combined with NCPAP treatment were included in atomization group (75 cases). The therapeutic effect, breathing conditions, blood gas changes [pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2)] and NCPAP parameters changes [fraction of inspired oxygen (FiO 2), oxygenation index (OI), positive end-expiratory pressure (PEEP)] before and after treatment and incidence rates of adverse reactions were compared between groups. Normally distributed quantitative data were expressed as xˉ± s, and t test was used for inter-group comparison. Counting data were expressed as case(%), and χ2 test was used for inter-group comparison. Comparison of repeated measurement indicators at different time points using repeated meausurement analysis of variance. Results:There was no statistical significance in the total effective rate of treatment between groups ( P>0.05). The NCPAP treatment time and oxygen therapy time were (4.69±0.61) d and (14.52±1.16) d in atomization group, significantly shorter than (5.08±0.80) d and (15.30±1.28) d in infusion group ( t=3.36, 3.91, P=0.001, <0.001). The success rate of one-time weaning in atomization group was 88.00% (66/75), significantly higher than 73.33% (55/75) in infusion group ( χ2=5.17, P=0.023). After 3 and 7 days of treatment, the pH [(3 d : 7.31±0.04, 7 d: 7.34±0.03) and (3 d: 7.35±0.03, 7 d: 7.38±0.02)], PaO 2 [(3 d: (58.55±6.51) mmHg (1 mmHg=0.133 kPa), 7 d: (68.19±7.58) mmHg ) and (3 d: (65.16±7.24) mmHg, 7 d: (75.57±8.40) mmHg)] in infusion group and atomization group increased obviously over time, and the pH and PaO 2 were significantly higher in atomization group than those in infusion group ( t=6.93, 8.68, 5.88, 5.65, all P<0.001). The PaCO 2 in infusion group and atomization group (3 d: (48.45±5.38 ) mmHg, 7 d: (43.64±4.85 ) mmHg) and (3 d: (45.41±5.02) mmHg, 7 d: (40.35±4.59) mmHg) decreased obviously over time at 3 and 7 days of treatment, and the PaCO 2 in atomization group was significantly lower than that in infusion group ( t=3.58, 4.27, both P<0.001). After 3 days of treatment, FiO 2 [(41.06±4.67)% and (38.52±4.21)%] and PEEP [(4.39±0.19) cmH 2O (1 cmH 2O=0.098 kPa) and (4.28±0.13) cmH 2O] in infusion group and atomization group decreased obviously, and the indicators in atomization group were significantly lower than those in infusion group ( t=3.50, 4.14, both P<0.001). After 3 days of treatment, oxygenation index (OI) in infusion group and atomization group [(278.35±30.48) mmHg and (296.67±32.96) mmHg] increased obviously, and the OI in atomization group was significantly higher than that in infusion group ( t=3.53, P<0.001). The incidence of adverse reactions in atomization group was 4.00% (3/75), significantly lower than 13.34% (10/75) in infusion group ( χ2=4.13, P=0.042). Conclusion:Both vibrating mesh atomization inhalation of PS or traditional infusion of PS combined with NCPAP have similar efficacy in the treatment of NRDS, but vibrating mesh atomization inhalation of PS combined with NCPAP can more effectively improve the breathing conditions, blood gas indicators and NCPAP parameters of children, and has higher safety.
