{"title":"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。","authors":"Shu-Ting Yang, Hao-Wei Chung, Hsiu-Lin Chen","doi":"10.1186/s12887-024-05167-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (SpO<sub>2</sub>), transcutaneous carbon dioxide (PtcCO<sub>2</sub>), and cerebral tissue oxygen saturation (StO<sub>2</sub>) at the end of NCPAP with HFNC support were recorded once daily for 3 days.</p><p><strong>Results: </strong>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, SpO<sub>2</sub>, and cerebral StO<sub>2</sub> during NCPAP weaning with HFNC were observed. However, the mean PtcCO<sub>2</sub> with NCPAP was statistically significantly lower than that with HFNC (46.9 ± 6.0 mmHg vs. 47.9 ± 6.4 mmHg, P = 0.02).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>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).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Feasibility and safety of weaning premature infants from nasal continuous positive airway pressure to high-flow nasal cannula: a prospective observational case study.\",\"authors\":\"Shu-Ting Yang, Hao-Wei Chung, Hsiu-Lin Chen\",\"doi\":\"10.1186/s12887-024-05167-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (SpO<sub>2</sub>), transcutaneous carbon dioxide (PtcCO<sub>2</sub>), and cerebral tissue oxygen saturation (StO<sub>2</sub>) at the end of NCPAP with HFNC support were recorded once daily for 3 days.</p><p><strong>Results: </strong>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, SpO<sub>2</sub>, and cerebral StO<sub>2</sub> during NCPAP weaning with HFNC were observed. However, the mean PtcCO<sub>2</sub> with NCPAP was statistically significantly lower than that with HFNC (46.9 ± 6.0 mmHg vs. 47.9 ± 6.4 mmHg, P = 0.02).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>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).</p>\",\"PeriodicalId\":9144,\"journal\":{\"name\":\"BMC Pediatrics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12887-024-05167-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12887-024-05167-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Feasibility and safety of weaning premature infants from nasal continuous positive airway pressure to high-flow nasal cannula: a prospective observational case study.
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).
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.
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