Application of noninvasive high frequency oscillatory ventilation in neonates with meconium aspiration syn-drome with pulmonary hypertension after extubation / 实用医学杂志

ABSTRACT

Objective To investigate the clinical value of nasal noninvasive high frequency oscillatory ven-tilation(NHFOV)as a respiratory support after exbutation by comparing it with nasal continuous positive airway pressure(NCPAP)in neonates with meconium aspiration syndrome(MAS)and persistent pulmonary hypertension (PPHN).Methods Infants of MAS with PPHN after exbutation from intensive care unit were randomly divided in-to NHFOV and NCPAP groups. The value of blood oxygen Pressure(PaO2),carbon dioxide partial pressure(Pa-CO2)and PaO2/FiO2at 1 h,12 h,24 h after exbutation were monitored.Results The NHFOV group showed low-er PaCO2than the NCPAP group at 1 h,12 h and 24 h after noninvasive respiratory support[1 h(41.1 ± 7.2)vs. (45.4 ± 6.7),P=0.000;12 h(38.9 ± 3.1)vs.(44.6 ± 5.2),P=0.000;24 h(35.1 ± 8.2)vs.(43.2 ± 7.1),P=0.000].There were no statistically significant difference of both PaO2and PaO2/FiO2at 1 h,12 h,24 h between the two groups(P>0.05).11.43% infants were failed to be extubated in NHFOV group,but 35.29% in NCPAP group, and there was significant difference between the two groups(P=0.021). Conclusion Compared with NCPAP, NHFOV can better reduce carbon dioxide retention in the sequential therapy for neonates after extubation,and it can also decrease the rate of extubation failure.