Clinical Analysis of 160 Cases of Initial Continuous Positive Airway Pressure in Premature Infants_West China Medical Journal

Authors：

 FanXue ,  ChenJuan

Department of Neonatology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ChenJuan, Email: chenjuan2000@163.com

Keywords：

Premature infant; Continuous positive airway pressure; Initial respiratory support; Efficacy

DOI：

10.7507/1002-0179.201600503

Video：

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Objective To analyze the application and efficacy of continuous positive airway pressure (CPAP) as an initial support measure for respiratory diseases in premature infants. Methods We retrospectively studied the clinical data of 160 premature infants hospitalized in the Neonatal Intensive Care Unit from January to December 2014. These infants accepted CPAP as the initial respiratory support. Results The average birth weight and the average gestational age of the 160 premature infants were (1 581±440) g and (31.6±1.9) weeks, respectively. The main diagnosis of the primary diseases in these infants included neonatal pneumonia (81.3%), neonatal respiratory distress syndrome (57.5%), neonatal apnea (53.8%) and neonatal asphyxia (22.5%). The CPAP success rate in those infants whose birth weight was less than 1 000 g was significantly lower than those whose birth weight was equal or greater than 1 000 g (χ²=4.882, P=0.027). The perinatal period analysis showed that premature rupture of membranes, intrauterine fetal distress and maternal pregnancy complications were factors correlating with the effect of CPAP. CPAP treatment analysis showed that early application of CPAP within 24 hours after birth had a success rate of 82.4% (108/131), and initial inhaled oxygen concentration and oxygen pressure were the primary factors affecting CPAP efficacy. Conclusion Application of CPAP is effective in respiratory support for premature infants and has a high success rate. Early application can reduce the use of mechanical ventilation and intubation. Regulating appropriate parameters helps raise the efficacy of CPAP therapy. Clinically, the standardized application of CPAP and monitoring the failure of CPAP are important for the improvement of the treatment efficacy.

Citation： FanXue, ChenJuan. Clinical Analysis of 160 Cases of Initial Continuous Positive Airway Pressure in Premature Infants. West China Medical Journal, 2016, 31(11): 1833-1836. doi: 10.7507/1002-0179.201600503 Copy

1.	陳超. 新生兒呼吸治療技術的臨床應用與規范[J].臨床兒科雜志, 2005, 23(3):189-192.
2.	劉霞, 黃綺薇. 持續呼吸道正壓在新生兒呼吸支持治療中的應用進展[J].國際兒科學雜志, 2006, 33(2):82-84.
3.	張玲, 蘇愛芳, 劉會杰, 等. 經鼻持續正壓通氣治療新生兒呼吸衰竭的臨床觀察[J].中國醫藥導刊, 2010, 12(11):2011-2012.
4.	Sankaran K, Adegbite M. Noninvasive respiratory support in neonates:a brief review[J].中國當代兒科雜志, 2012, 14(9):643-652.
5.	袁艷冰, 劉海燕, 鐘倩. 早產兒呼吸機治療的圍生期高危因素分析[J].新醫學, 2014, 45(6):399-402.
6.	Ammari A, Suri M, Milisavljevic V, et al. Variables associated with the early failure of nasal CPAP in very low birth weight infants[J].J Pediatr, 2005, 147(3):341-347.
7.	陳信, 潘家華. 無創通氣在早產兒呼吸窘迫綜合征中的應用進展[J].中國當代兒科雜志, 2014, 16(11):1177-1182.
8.	Pillai MS, Sankar MJ, Mani K, et al. Clinical prediction score for nasal CPAP failure in pre-term VLBW neonates with early onset respiratory distress[J].J Trop Pediatr, 2011, 57(4):274-279.
9.	Colin J, Morley MD, Peter G, et al. Nasal CPAP or intubation at birth for very preterm infants[J].N Engl J Med, 2008, 358(7):700-708.
10.	Schm?lzer GM, Kumar M, Pichler G, et al. Non-invasive versus invasive respiratory support in preterm infants at birth:systematic review and meta-analysis[J].BMJ, 2013, 347:f5980.
11.	金英蘭. 固爾蘇聯合CPAP治療早產兒呼吸窘迫綜合征的臨床研究[J].中國現代醫生, 2011, 49(34):57-58, 60.
12.	Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterminfants--2013 update[J].Neonatology, 2013, 103(4):353-368.
13.	Meneses J, Bhandari V, Alves JG. Noninvasive ventilation for respiratory distress syndrome:a randomized controlled trial[J].Pediatrics, 2011, 127(2):300-307.
14.	Dargaville PA, Aiyappan A, De Paoli AG, et al. Continuous positive airway pressure failure in preterm infants:incidence, predictors and consequences[J].Neonatology, 2013, 104(1):8-14.
15.	Committee on Fetus, Newborn. American academy of pediatrics. respiratory support in preterm infants at birth[J].Pediatrics, 2014, 133(1):171-174.

1. 陳超. 新生兒呼吸治療技術的臨床應用與規范[J].臨床兒科雜志, 2005, 23(3):189-192.
2. 劉霞, 黃綺薇. 持續呼吸道正壓在新生兒呼吸支持治療中的應用進展[J].國際兒科學雜志, 2006, 33(2):82-84.
3. 張玲, 蘇愛芳, 劉會杰, 等. 經鼻持續正壓通氣治療新生兒呼吸衰竭的臨床觀察[J].中國醫藥導刊, 2010, 12(11):2011-2012.
4. Sankaran K, Adegbite M. Noninvasive respiratory support in neonates:a brief review[J].中國當代兒科雜志, 2012, 14(9):643-652.
5. 袁艷冰, 劉海燕, 鐘倩. 早產兒呼吸機治療的圍生期高危因素分析[J].新醫學, 2014, 45(6):399-402.
6. Ammari A, Suri M, Milisavljevic V, et al. Variables associated with the early failure of nasal CPAP in very low birth weight infants[J].J Pediatr, 2005, 147(3):341-347.
7. 陳信, 潘家華. 無創通氣在早產兒呼吸窘迫綜合征中的應用進展[J].中國當代兒科雜志, 2014, 16(11):1177-1182.
8. Pillai MS, Sankar MJ, Mani K, et al. Clinical prediction score for nasal CPAP failure in pre-term VLBW neonates with early onset respiratory distress[J].J Trop Pediatr, 2011, 57(4):274-279.
9. Colin J, Morley MD, Peter G, et al. Nasal CPAP or intubation at birth for very preterm infants[J].N Engl J Med, 2008, 358(7):700-708.
10. Schm?lzer GM, Kumar M, Pichler G, et al. Non-invasive versus invasive respiratory support in preterm infants at birth:systematic review and meta-analysis[J].BMJ, 2013, 347:f5980.
11. 金英蘭. 固爾蘇聯合CPAP治療早產兒呼吸窘迫綜合征的臨床研究[J].中國現代醫生, 2011, 49(34):57-58, 60.
12. Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterminfants--2013 update[J].Neonatology, 2013, 103(4):353-368.
13. Meneses J, Bhandari V, Alves JG. Noninvasive ventilation for respiratory distress syndrome:a randomized controlled trial[J].Pediatrics, 2011, 127(2):300-307.
14. Dargaville PA, Aiyappan A, De Paoli AG, et al. Continuous positive airway pressure failure in preterm infants:incidence, predictors and consequences[J].Neonatology, 2013, 104(1):8-14.
15. Committee on Fetus, Newborn. American academy of pediatrics. respiratory support in preterm infants at birth[J].Pediatrics, 2014, 133(1):171-174.

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Clinical Analysis of 160 Cases of Initial Continuous Positive Airway Pressure in Premature Infants

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