ABSTRACT
Objective To compare the efficacy and safety of humidified high-flow nasal cannula (HHFNC)and nasal continuous positive airway pressure (nCPAP) for moderate and severe bronchiolitis treatment in infants.Methods Thirty-two infants who were diagnosed as moderate and severe bronchiolitis admitted to Department of Pediatric Critical Care Medicine,the Affiliated Hospital of Qingdao University from September 2016 to May 2017 were selected,and they were randomly assigned into HHFNC group(17 cases) and nCPAP group(15 cases).The heart rate,breathing,oxygen saturation (SpO2),arterial partial pressure of oxygen [Pa (O2)],partial pressure of carbon dioxide [Pa (CO2)],pH value after treatment for 12 h,the duration of non-invasive ventilation and the incidence rates of invasive ventilation use,complications were compared between the 2 groups.Results After the treatment for 12 h,in HHFNC group,the heart rate was (130.88 ± 2.87) times/min,respiratory rate was (37.35 ± 3.55) times/min,SpO2 was(97.06 ± 1.43)％,pa(O2) was (99.65-±8.07) mmHg,pa(CO2) was (35.88 ±4.27) mmHg,pH was 7.42 ± 0.03;while in the nCPAP group,the heart rate was (135.73 ± 6.29) times/min,respiratory rate was (41.40 ± 4.40)times/min,SpO2 was (96.00 ± 1.13) ％,Pa (O2) was (91.33 ± 9.45) mmHg,pa (CO2) was (40.13 ± 3.72)mmHg,pH was 7.39 ± 0.03.The breathing,heart rate,oxygen saturation and arterial blood gas in both groups after treatment were improved significantly compared with those before treament,and the differences were statistically significant (all P ＜ 0.05);after treatment for 12 h,the heart rate,breathing,oxygen saturation and arterial blood gas of HHFNC group were improved more than those of the nCPAP group,and the differences had statistical significance (all P ＜ 0.05).The duration of non-invasive ventilation was (45.88-± 6.49) hours in HHFNC group,and (49.33 ± 8.99) hours in nCPAP group,so there was no difference between the 2 groups (t =1.254,P =0.219).There was 12 cases (80.0％) of mild complication in nCPAP group and 5 cases(29.4％) in HHFNC group,while the incidence rate of invasive ventilation use was 3 cases(20.0％) in nCPAP group and 1 case (5.9％) in HHFNC group.Conclusion The efficacy and security of HHFNC on moderate and severe bronchiolitis are better than those of nCPAP,and it is recommended for clinical application widely.
ABSTRACT
Objective To compare the efficacy and safety of humidified high-flow nasal cannula (HHFNC)and nasal continuous positive airway pressure (nCPAP) for moderate and severe bronchiolitis treatment in infants.Methods Thirty-two infants who were diagnosed as moderate and severe bronchiolitis admitted to Department of Pediatric Critical Care Medicine,the Affiliated Hospital of Qingdao University from September 2016 to May 2017 were selected,and they were randomly assigned into HHFNC group(17 cases) and nCPAP group(15 cases).The heart rate,breathing,oxygen saturation (SpO2),arterial partial pressure of oxygen [Pa (O2)],partial pressure of carbon dioxide [Pa (CO2)],pH value after treatment for 12 h,the duration of non-invasive ventilation and the incidence rates of invasive ventilation use,complications were compared between the 2 groups.Results After the treatment for 12 h,in HHFNC group,the heart rate was (130.88 ± 2.87) times/min,respiratory rate was (37.35 ± 3.55) times/min,SpO2 was(97.06 ± 1.43)％,pa(O2) was (99.65-±8.07) mmHg,pa(CO2) was (35.88 ±4.27) mmHg,pH was 7.42 ± 0.03;while in the nCPAP group,the heart rate was (135.73 ± 6.29) times/min,respiratory rate was (41.40 ± 4.40)times/min,SpO2 was (96.00 ± 1.13) ％,Pa (O2) was (91.33 ± 9.45) mmHg,pa (CO2) was (40.13 ± 3.72)mmHg,pH was 7.39 ± 0.03.The breathing,heart rate,oxygen saturation and arterial blood gas in both groups after treatment were improved significantly compared with those before treament,and the differences were statistically significant (all P ＜ 0.05);after treatment for 12 h,the heart rate,breathing,oxygen saturation and arterial blood gas of HHFNC group were improved more than those of the nCPAP group,and the differences had statistical significance (all P ＜ 0.05).The duration of non-invasive ventilation was (45.88-± 6.49) hours in HHFNC group,and (49.33 ± 8.99) hours in nCPAP group,so there was no difference between the 2 groups (t =1.254,P =0.219).There was 12 cases (80.0％) of mild complication in nCPAP group and 5 cases(29.4％) in HHFNC group,while the incidence rate of invasive ventilation use was 3 cases(20.0％) in nCPAP group and 1 case (5.9％) in HHFNC group.Conclusion The efficacy and security of HHFNC on moderate and severe bronchiolitis are better than those of nCPAP,and it is recommended for clinical application widely.
ABSTRACT
Objective To study the curative effect of inhaled corticosteroids in the treatment of infant with wheezy bronchitis through clinical symptom score. Methods One hundred infant of 4-23 months old with wheezy bronchitis treated were enrolled. According to the clinical symptom score, they were divided into light group (40 cases), moderate group (30 cases) and severe group (30 cases). Patients in each group were divided into atomization group and control group by random digits table. The clinical symptom score was compared between before treatment and after treatment. Results In light, moderate and severe group, the clinical symptom scores 24, 48, 72 h after treatment in atomization group were significantly lower than those in control group (P<0.01 or<0.05). In light, moderate and severe group, the clinical symptom scores in atomization group were significantly decreased 24 h after treatment (P <0.05). In light and moderate group, the clinical symptom scores in control group were significantly decreased 48 h after treatment (P < 0.05), and in severe group, the clinical symptom score in control group was significantly decreased 72 h after treatment (P < 0.05). Factorial design data of variance analysis showed that in the treatment method, there were significantly differences between atomization group and control group (F=66.393, 5.093 and 154.326;P<0.01), in the treatment time aspect, there were significantly differences between atomization group and control group (F = 263.836, 182.568 and 75.587;P<0.01), and in terms of treatment method × time, there were significantly differences between atomization group and control group (F = 13.956, 6.414 and 5.628; P < 0.01). Conclusions Inhaled corticosteroids therapy in light, moderate and severe infant wheezy bronchitis can obviously improve the clinical symptoms and reduce the clinical symptom scores.