[Apllication of nasal synchronous intermittent mandatory ventilation in premature infants with severe respiratory distress syndrome after extubation].

OBJECTIVE: To study the clinical efficacy of nasal synchronous intermittent mandatory ventilation (nSIMV) in premature infants with severe respiratory distress syndrome (RDS) after extubation. METHODS: A retrospective analysis on the clinical date of 126 premature infants with severe RDS who were hospitalized in the NICU between January 2013 and May 2015 was performed. Sixty-one premature infants who were hospitalized in the NICU between January 2013 and March 2014 received nasal continuous positive airway pressure (nCPAP) (nCPAP group) and 65 premature infants who were hospitalized in the NICU between April 2014 and May 2015 received nSIMV (nSIMV group). The blood gas analysis indexes, the rate of extubation failure, the causes of extubation failure and the incidence of complications were compared between the two groups. RESULTS: After 4 hours of treatment, the pH value, PaO2, SaO2 and oxygenation index in the nSIMV group were significantly higher than in the nCPAP group (P<0.05), meanwhile, the PaCO2 in the nSIMV group were significantly lower than in the nCPAP group (P<0.05). The rates of extubation failure in the nSIMV and nCPAP groups were 9% (6/65) and 30% (18/61) respectively (P<0.05). The extubation failure in the nSIMV and nCPAP groups was caused by hyoxemia (2% vs 5%; P>0.05), hypercapnia (6% vs 11%; P>0.05) and apnea (2% vs 13%; P<0.05). There were no differences in respirator support time, full enteral feeding time, the time to regain birth weight and the length of hospitalization between two groups (P>0.05). After treatment, the incidence of abdominal distension in the nSIMV group was significantly lower than in the nCPAP group (9% vs 30%; P<0.05) and there were no differences in the incidences of feeding intolerance, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity and bronchopulmonory dysplasia between the two groups. CONCLUSIONS: nSIMV for premature infants with severe RDS after extubation not only significantly improves lung function and reduces the rate of extubation failure, also results in a lower incidence of gastrointestinal side effects and does not increase the incidence of complications.

Sublingual Immunotherapy for Asthmatic Children Sensitized to House Dust Mite: A Meta-Analysis.

The house dust mite is one of the most common allergens worldwide. There is good evidence that house dust mite subcutaneous immunotherapy is efficacious and has long-term benefit in children. However, the evidence of the benefit of house dust mite sublingual immunotherapy (SLIT) is less convincing. The purpose of this meta-analysis was to evaluate that efficacy and safety of dust mite SLIT in children with asthma. Medical Literature Analysis and Retrieval System Online, ISI Web of Knowledge, and Cochrane Central Register of Controlled Trials databases until February 2014 were searched. The primary outcome was mean change in asthma symptom score. Secondary outcomes included mean change in serum immunoglobulin G4 (sIgG4), specific Dermatophagoides pteronyssinus, immunoglobulin E (IgE) levels, and medication score. Safety was also assessed. We found that SLIT significantly decreased asthma symptom score (P = 0.007) and increased sIgG4 levels (P = 0.011) greater than control in children (<18 years of age) with asthma. There was no difference between SLIT and control groups in specific D pteronyssinus IgE levels (P = 0.076) and medication score (P = 0.408). The safety profile was similar between groups. Our study indicates that dust mite SLIT therapy was effective in reducing asthma symptoms and in increasing sIgG4 but did not significantly reduce medication scores or specific D pteronyssinus IgE levels. Our findings are not enough to support the use of dust mite SLIT in children with asthma.