Application of permissive hypercapnia in premature infants with respiratory distress syndrome / 中国小儿急救医学

ABSTRACT

Objective:To analyze the effect of permissive hypercapnia(PHC) in premature infants with respiratory distress syndrome(RDS).Methods:Seventy preterm infants diagnosed with RDS from July 2019 to September 2020 were enrolled.The preterm infants were divided into PHC group[noninvasive high-frequency ventilation(NHFV)+ PHC, n=34] and non PHC group(NHFV, n=36)after injection of pulmonary surfactant by LISA method.Ventilator parameters, time of ventilation, oxygen therapy, enteral feedingand hospitalization days were compared between the two groups.The incidences of patent ductus arteriosus, intracranial hemorrhage, pneumothorax and ventilator-induced lung injury were recorded. Results:The time of mechanical ventilation, oxygen therapy, age of enteral feeding and hospitalization time in PHC group were less than those in non PHC group( P<0.05). PaO 2 and PaCO 2 of the two groups had no difference before mechanical ventilation treatment( P>0.05), and PaO 2 of the two groups had no difference after 24 hours of treatment( P>0.05). After treatment, PaCO 2 in non PHC group was significantly lower, and there was no significant difference in PHC group( P<0.05). There was no significant difference regarding ventilator parameters MAP and FiO 2 after 24 hours of treatment between the two groups( P>0.05), and the &Delta;P of PHC group was significantly lower than that of non-PHC group ( P<0.05). The incidence of ventilator-induced lung injury in PHC group was lower than that in non-PHC group( P<0.05). Conclusion:Compared with conventional ventilation therapy, PHC has similar therapeutic effect, but it can shorten the mechanical ventilation time, oxygen therapy time, age of enteral feeding and hospitalization days, and reduce the incidence of ventilator-induced lung injury.