Caffeine combined with heated humidified high-flow nasal cannula in the treatment of respiratory distress syndrome in preterm infants

Abstract

Objective To observe the clinical efficacy and safety of caffeine citrate combined with heated humidified high-flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) in preterm infants. Methods From June 2017 to December 2018, a total of 82 preterm infants with RDS (28 weeks≤ gestational age<32 weeks) who were hospitalized in Neonatal Intensive Care Unit of the Affiliated Xuzhou Hospital of Southeast University were chosen as research subjects. They were randomly (random number table method) divided into two groups: the combined treatment group (n=42) and the control group (n=40). Infants in the combined treatment group were given caffeine citrate combined with HHHFNC, while infants in the control group were given nasal continuous positive airway pressure (NCPAP) without caffeine citrate. The general clinical data, results of blood gas analysis at 6 h and 24 h after breath support therapy, clinical efficacy, related complications and adverse drug reactions between the two groups were compared statistically by LSD-t test, Chi-square test and Kruskal-Wallis H rank sum test. Results ① No significant differences were found between the two groups in the general clinical data (all P>0.05).②The results of intra-groups comparison within the combined treatment group or control group showed that the pH value, partial pressure of arterial carbon dioxide (PaCO2), partial pressure of arterial oxygen (PaO2) of blood gas analysis and PaO2/fraction of inspired oxygen (P/F) at 6 h and 24 h after breath support therapy were all significantly improved compared to those of before treatment (all P 0.05). Conclusions Caffeine citrate combined with HHHFNC treatment strategy for premature infants with RDS can effectively improve oxygenation, shorten the duration of noninvasive mechanical ventilation, increase the success rate of machine withdrawal, and reduce the incidence of nasal trauma and abdominal distention. Key words: Caffeine; Heated humidified high-flow nasal cannula; Continuous positive airway pressure; Respiratory distress syndrome; Infant, preterm