Clinical observation of nasal continuous positive airway pressure in treatment of severe pneumonia in children / 中国小儿急救医学

ABSTRACT

Objective To evaluate the efficacy and safety of nasal continuous positive airway pres-sure (NCPAP) in treatment of severe pneumonia in children. Methods A series of 150 children with severe pneumonia were prospectively included from January 2016 to June 2017. The 150 children all still had short-ness of breath after 1 hours of nasal oxygen delivery,and then switched to NCPAP. We collected related clini-cal parameters (the basic vital signs,blood gas analysis index,shortness of breath,wheezing,groaning,nasal incitement,three depressions sign and NCPAP parameters) at three time points,including 0 h,1 h,4 h after using NCPAP. We compared the clinical parameters among the three time points before and after NCPAP with the purpose to assess the efficacy and safety of NCPAP. Results The proportion of shortness of breath (χ2=272. 218,P=0. 01),fast heart rate(χ2=31. 625,P=0. 01),wheezing(χ2=7. 624,P=0. 02),moaning (χ2=7. 203,P=0. 025),nasal flaring(χ2=74. 032,P＜0. 01),three depressions sign(χ2=117. 030,P＜0. 01) gradually decreased with statistically different among 0 h,1 h and 4 h after using NCPAP. PaO2/FiO2 (F=7. 32,P＜0. 01) gradually increased with statistically different among 0 h,1 h and 4 h after using NCPAP. Twenty-seven patients required intubations. PaO2and PaO2/FiO2in patiens received intubations were lower than those in patients only received NCPAP before treatment. Conclusion NCPAP is an effective and safe way for severe pneumonia children who remained abnormal breathing after conventional oxygen inhalation.