Comparison of the clinical effects of different ventilation modes combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome / 中国小儿急救医学

ABSTRACT

Objective To compare the clinical efficacy and the complications of two ventilation modes in the premature infants with neonatal respiratory distress syndrome(NRDS).Two different noninva-sive ventilation methods,synchronized nasal intermittent positive pressure ventilation(SNIPPV) and nasal continuous positive airway pressure(NCPAP) combined with Curosurf were used in the treatment of patients with NRDS.Methods A retrospective study was conducted in 46 infants with NRDS admitted to our hospi-tal during January 2016 to December 2017. The subjects were divided into SNIPPV group(n =24) and NCPAP group(n =22),respectively combined with Curosurf treatment. PaO2,PaCO2,oxygenation index (OI)(PaO2/FiO2),duration of oxygen therapy,noninvasive ventilation time,reintubation cases for the use of pulmonary surfactant,starting time of feeding,length of hospital stay,incidence of abdominal distention, intracranial hemorrhage,air leakage and other complications were compared between the two groups before and after treatment.Results After treatment,the blood gas indexes of PaO2and OI at 24 h both in the two groups were significantly higher than those before the treatment(P<0.05).After treatment,PaCO2was lower in both SNIPPV group and NCPAP group,but there was no statistical difference between the two groups(P>0.05).The OI at 24 h[(219 ± 23)mmHg,1 mmHg=0.133 kPa] was significantly higher in SNIPPV group than that in NCPAP group[(199 ± 26)mmHg](P<0.05).There was no difference in PaO2,PaCO2and OI between the two groups before treatment.Duration of oxygen therapy,starting time of feeding,the time of using noninvasive ventilation,length of hospital stay were shorter in SNIPPV group[(82.8 ± 11.7)h vs. (107.6 ± 20.3)h,(32.0 ± 8.0)h vs.(47.0 ± 7.2)h,(62.3 ± 10.8)h vs.(99.6 ± 17.1)h,(12.0 ± 3.5)d vs.(15.0 ± 3.8)d] than those in NCPAP group,the differences were statistically significant(P <0.05). Reintubation cases for the use of pulmonary surfactant and the incidence rate of abdominal distension, intracranial hemorrhage,air leakage showed no statistical significance between the two groups(P>0.05). Conclusion SNIPPV and NCPAP combined with Curosurf treatment have similar clinical effects in premature infants with NRDS. While SNIPPV can reduce the starting time of feeding,the time of using noninvasive ventilation,duration of oxygen therapy,length of hospital stay in the patients with NRDS,and the clinical effect is more significant.