High-flow nasal cannula for stabilisation of very premature infants: A prospective observational study.

IF 2.4 4区 医学 Q1 PEDIATRICS
Acta Paediatrica Pub Date : 2024-11-25 DOI:10.1111/apa.17519
Klára Jonáš, Tereza Lamberská, Truong An Nguyen, Petr Kudrna, Richard Plavka
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引用次数: 0

Abstract

Aim: To assess the feasibility, safety and efficacy of using a high-flow nasal cannula (HFNC) for stabilising very preterm infants after birth.

Methods: A prospective observational study included preterm infants born at 28 + 0 to 31 + 6 weeks' gestation between February 2021 and December 2022 at the General University Hospital in Prague. Following delayed cord clamping, HFNC was administered at a flow rate of 8 L/min through the infants' nostrils. Criteria for switching to continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) included persistent bradycardia in the first few minutes or low saturation of oxygen (SpO2) after 5 min, respectively.

Results: Of the 65 infants enrolled in the study, 56 (86%) were successfully stabilised exclusively using HFNC while 7 (11%) required PPV. Additionally, 52 (80%) infants achieved SpO2 > 80% at 5 min, and 54 (83%) infants were successfully treated with HFNC within the first 3 h of life.

Conclusion: The primary use of HFNC seems to be an appropriate alternative to CPAP for the stabilisation of very premature infants after birth and subsequent transfer to the NICU. A randomised trial comparing HFNC and CPAP in the delivery room will enable to answer the questions raised in this study.

用于稳定极早产儿病情的高流量鼻插管:前瞻性观察研究。
目的:评估使用高流量鼻插管(HFNC)稳定极早产儿出生后病情的可行性、安全性和有效性:这项前瞻性观察研究包括 2021 年 2 月至 2022 年 12 月期间在布拉格综合大学医院出生的妊娠 28+0 周至 31+6 周的早产儿。延迟脐带钳夹后,以 8 L/min 的流速通过婴儿的鼻孔进行 HFNC 给药。转用持续气道正压(CPAP)或正压通气(PPV)的标准分别包括最初几分钟内持续心动过缓或 5 分钟后血氧饱和度(SpO2)过低:在参与研究的 65 名婴儿中,有 56 名(86%)完全使用高频核磁共振成功稳定了病情,有 7 名(11%)需要 PPV。此外,52 名婴儿(80%)在 5 分钟后 SpO2 > 80%,54 名婴儿(83%)在出生后 3 小时内成功接受了 HFNC 治疗:结论:对于出生后转入新生儿重症监护室的极早产儿,主要使用 HFNC 似乎是替代 CPAP 的合适方法。在产房比较 HFNC 和 CPAP 的随机试验将有助于回答本研究提出的问题。
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
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
期刊介绍: Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries
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