Comparison of Effects between Nasal Bi-Level Positive Airway Pressure and Nasal Synchronized Intermittent Mandatory Ventilation in Neonatal Respiratory Distress Syndrome.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL British journal of hospital medicine Pub Date : 2024-11-30 Epub Date: 2024-11-18 DOI:10.12968/hmed.2024.0454
Yu Zhang, Juan Zhang
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Abstract

Aims/Background Neonatal respiratory distress syndrome (NRDS) is characterized by progressive aggravation and rapid progression of respiratory distress, with a high incidence rate among premature infants. If left untreated, NRDS results in a poor prognosis. In recent years, various respiratory support modalities have received extensive attention in clinical practice. The therapeutic effect of different respiratory support modes on NRDS has gradually become the focus of clinical research. The aim of this study was to explore the therapeutic effects of nasal bi-level positive airway pressure (nBiPAP) and nasal synchronized intermittent mandatory ventilation (nSIMV) on NRDS. Methods This study retrospectively analyzed the clinical data of 157 newborns with NRDS in the Mudanjiang Medical University Affiliated Second Hospital from January 2021 to December 2023, finally including 153 cases after excluding 4 cases with missing clinical data. According to the non-invasive ventilation method, these newborns were categorized into a nBiPAP group (receiving nBiPAP treatment, n = 77) and an nSIMV group (receiving nSIMV treatment, n = 76). The blood gas indices, using time of ventilator, hospitalization time, therapeutic effects, and incidence of complications were compared between the two groups. Results The PaCO2, PaO2, and pH levels in the nBiPAP group were basically consistent with those in the nSIMV group before and after treatment (p > 0.05). The use time of ventilator, hospitalization time, and therapeutic effects in the nBiPAP group were similar to those in the nSIMV group (p > 0.05). Additionally, both groups demonstrated no significant difference in the incidence of complications such as intraventricular hemorrhage, apnea, necrotizing enterocolitis, and feeding intolerance (p > 0.05). The incidence rates of ventilator-associated lung injury and neonatal bronchopulmonary dysplasia in the nBiPAP group were lower than those in the nSIMV group, with a significant difference (p < 0.05). Conclusion Both nBiPAP and nSIMV have shown good effects in treating NRDS, with nBiPAP showing a significant advantage in reducing the incidence rates of complications such as ventilator-associated lung injury and neonatal bronchopulmonary dysplasia.

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鼻双水平气道正压通气与鼻同步间歇强制通气治疗新生儿呼吸窘迫综合征的效果比较。
目的/背景新生儿呼吸窘迫综合征(NRDS)以呼吸窘迫的进行性加重和快速进展为特征,在早产儿中发病率高。如果不及时治疗,NRDS会导致预后不良。近年来,各种呼吸支持方式在临床实践中得到了广泛的关注。不同呼吸支持方式对NRDS的治疗效果逐渐成为临床研究的热点。本研究的目的是探讨鼻双水平气道正压通气(nBiPAP)和鼻同步间歇强制通气(nSIMV)对NRDS的治疗效果。方法回顾性分析牡丹江医科大学附属第二医院2021年1月至2023年12月157例新生儿NRDS的临床资料,剔除临床资料缺失的4例,最终纳入153例。根据无创通气方法将新生儿分为nBiPAP组(接受nBiPAP治疗,n = 77)和nSIMV组(接受nSIMV治疗,n = 76)。比较两组患者血气指标、呼吸机使用时间、住院时间、治疗效果、并发症发生率。结果nBiPAP组治疗前后PaCO2、PaO2、pH水平与nSIMV组基本一致(p < 0.05)。nBiPAP组呼吸机使用时间、住院时间及治疗效果与nSIMV组相似(p < 0.05)。此外,两组在脑室内出血、呼吸暂停、坏死性小肠结肠炎、喂养不耐受等并发症发生率方面无显著差异(p < 0.05)。nBiPAP组呼吸机相关肺损伤及新生儿支气管肺发育不良发生率均低于nSIMV组,差异有统计学意义(p < 0.05)。结论nBiPAP与nSIMV治疗NRDS均有较好的疗效,其中nBiPAP在降低呼吸机相关肺损伤、新生儿支气管肺发育不良等并发症发生率方面具有显著优势。
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来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
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