Feasibility and safety of weaning premature infants from nasal continuous positive airway pressure to high-flow nasal cannula: a prospective observational case study.

IF 2 3区医学 Q2 PEDIATRICS

BMC Pediatrics Pub Date : 2024-11-15 DOI:10.1186/s12887-024-05167-2

Shu-Ting Yang, Hao-Wei Chung, Hsiu-Lin Chen

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引用次数: 0

Abstract

Background: Nasal continuous positive airway pressure (NCPAP) is widely used for premature infants with respiratory distress syndrome (RDS). A high-flow nasal cannula (HFNC) provides positive end-expiratory pressure using high-flow oxygen; however, the variability in distending pressure is a primary concern. This study evaluated the feasibility and safety of a newly designed protocol for NCPAP weaning with cyclic HFNC use for premature infants.

Methods: Premature infants with RDS using NCPAP support who were ready for weaning were enrolled. The weaning protocol used cyclic NCPAP with HFNC every 3 h for 3 days in the neonatal intensive care unit. The heart rate (HR), respiratory rate (RR), pulse oximetry (SpO₂), transcutaneous carbon dioxide (PtcCO₂), and cerebral tissue oxygen saturation (StO₂) at the end of NCPAP with HFNC support were recorded once daily for 3 days.

Results: From June 2019 to April 2021, 46 premature infants (27 male, 19 female) were enrolled. The mean gestational age and birth body weight were 28.7 ± 2.6 weeks and 1181 ± 354 g, respectively. No statistically significant differences in the HR, RR, SpO₂, and cerebral StO₂ during NCPAP weaning with HFNC were observed. However, the mean PtcCO₂ with NCPAP was statistically significantly lower than that with HFNC (46.9 ± 6.0 mmHg vs. 47.9 ± 6.4 mmHg, P = 0.02).

Conclusions: The feasibility and safety of the NCPAP weaning protocol with cyclic HFNC for premature infants are acceptable in this preliminary study. Due to the limited number of participants, further studies are required for more comprehensive analysis.

Trial registration: This prospective observational case study was approved by the Human Experiment and Ethics Committee of our hospital (approval number: KMUHIRB-SV(I)-20180059; approval date: January 11, 2019).

查看原文本刊更多论文

早产儿从鼻持续气道正压到高流量鼻插管断奶的可行性和安全性：前瞻性观察病例研究。

背景：鼻腔持续气道正压（NCPAP）被广泛应用于患有呼吸窘迫综合征（RDS）的早产儿。高流量鼻插管（HFNC）使用高流量氧气提供呼气末正压；然而，胀气压力的变化是一个主要问题。本研究评估了新设计的早产儿周期性使用高流量鼻导管进行 NCPAP 断流的方案的可行性和安全性：方法：研究人员招募了准备断奶的使用 NCPAP 支持的 RDS 早产儿。断奶方案在新生儿重症监护室使用循环 NCPAP，每 3 小时使用一次 HFNC，持续 3 天。每天记录一次 NCPAP 与 HFNC 支持结束时的心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2）、经皮二氧化碳（PtcCO2）和脑组织氧饱和度（StO2），持续 3 天：2019年6月至2021年4月，46名早产儿（27名男婴，19名女婴）入组。平均胎龄和出生体重分别为（28.7 ± 2.6）周和（1181 ± 354）克。在使用 HFNC 进行 NCPAP 断奶期间，未观察到 HR、RR、SpO2 和脑 StO2 有明显的统计学差异。然而，NCPAP的平均PtcCO2在统计学上明显低于HFNC（46.9 ± 6.0 mmHg vs. 47.9 ± 6.4 mmHg，P = 0.02）：在这项初步研究中，早产儿使用循环 HFNC 的 NCPAP 断奶方案的可行性和安全性是可以接受的。由于参与人数有限，需要进一步研究以进行更全面的分析：这项前瞻性观察病例研究已获得本院人体实验和伦理委员会批准（批准号：KMUHIRB-SV）：KMUHIRB-SV(I)-20180059；批准日期：2019年1月11日）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pediatrics PEDIATRICS-

CiteScore

3.70

自引率

4.20%

发文量

683

审稿时长

3-8 weeks

期刊介绍： BMC Pediatrics is an open access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children and adolescents, as well as related molecular genetics, pathophysiology, and epidemiology.