Study On The Application Effect And Safety Of NHFOV In RDS Of Premature Infants

Objective: to evaluate the safety and efficacy of transnasal noninvasive high frequency oscillatory ventilation(NHFOV)in the treatment of premature infants with respiratory distress syndrome.Methods: select 2017~10 month in February 2019 in the first affiliated hospital,school of medicine in the south of anhui(Yi rocky mountain hospital neonatal intensive care unit(NICU)in the hospital,gestational age is 32 ~ 35 weeks premature,a total of 60 cases with RDS in this randomized controlled study,and was born in 12 hours exogenous pulmonary surface active substances(PS)replacement therapy.Sixty cases of premature infants were randomly divided into two groups by random counting table,and adopted NHFOV mode and NCPAP mode respectively.30 cases were included in the NHFOV group,among which 6 cases were replaced by invasive mechanical ventilation due to failure of non-invasive ventilation,1 case was abandoned by the family members,and 23 cases were finally completed.30 patients were included in the NCPAP group,and 5 patients were replaced by invasive mechanical ventilation due to failure of non-invasive ventilation,and 25 patients were finally completed.Data collection with the general basic information,including: children with gestational age,birth weight,sex,whether mother prenatal used hormone,whether mother antenatal whether to have basic diseases,amniotic fluid contamination,childbirth way,is there a premature rupture of membranes,admitted to using lung surface active material time,pulmonary dosage of surface active substance,1 min Apgar score,Apgar score 5 minand other basic information;Arterial blood gas analysis was performed at 0h before and12 h,24h and 48 h after assisted ventilation for the children,and pH,carbon dioxide partial pressure(PaCO2),blood oxygen partial pressure(PaO2)and oxygenation index(OI)in different time periods were compared between the two non-invasive ventilation modes.The duration of non-invasive ventilation,total oxygen therapy,length of hospital stay,rate of weight gain,time to start intestinal feeding,time to complete intestinal feeding,rate of re-intubation failure of non-invasive ventilation,and cases of VAP,BPD,NEC,PIVH,PNH,PVL,ROP,pneumothorax and other complications were compared between the two groups under non-invasive ventilation mode.Results: NHFOV and NCPAP group of 23 cases and 25 cases respectively,including NHFOV group and NCPAP gestational age,birth weight,sex between the two groups,pregnant women with and without serious complications during pregnancy and childbirth way,amniotic fluid pollution situation,the presence of premature rupture of membranes,prenatal hormone use,dosage of PS,born to use PS time,1 min Apgar score,Apgar score on 5 min after statistics treatment showed no statistical difference(P > 0.05).The PH values of children in NHFOV group and NCPAP group at 0h before,12 h after,24 h and 48 h after adjuvant ventilation showed no statistical difference(P >0.05).There was no statistical difference in PaCO2 between NHFOV group and NCPAP group at 0h before assisted ventilation(P > 0.05).The corresponding PaCO2 of NHFOV group and NCPAP group at different time points 12 h,24h and 48 h after auxiliary ventilation showed statistical difference after statistical treatment(P < 0.05),and the PaCO2 of NHFOV group was lower than that of NCPAP group.PaO2 values of NHFOV group and NCPAP group showed no statistical difference before auxiliary ventilation and after auxiliary ventilation for 24 h and 48h(P > 0.05),while PaO2 values of 12 h after auxiliary ventilation showed statistical difference(P < 0.05).PaO2 values of NHFOV group were higher than those of NCPAP group.OI values of NHFOV group and NCPAP group before assisted ventilation(0h)and 24 h and 48 h after assistedventilation showed no statistical difference(P > 0.05),and OI values of 12 h after assisted ventilation showed statistical difference(P < 0.05).OI values of NHFOV group were higher than those of NCPAP group.The duration of noninvasive ventilation,length of hospital stay,rate of weight gain,time to start intestinal feeding,and time to start whole intestinal feeding in the NHFOV group and NCPAP group showed no statistical difference(P > 0.05).After statistical treatment,there was a statistical difference in total oxygen treatment time between the two groups(P < 0.05).The total oxygen therapy time of assisted ventilation in NHFOV group was shorter than that in NCPAP group..The failure rate,VAP,BPD and PIVH of NCPAP and NHFOV showed no statistical difference.No cases of NEC,PNH,PVL,ROP or pneumothorax were found in the NHFOV group and NCPAP group.Conclusion: 1.Compared with NCPAP,NHFOV can significantly improve CO2 retention,rapidly improve PaO2,and shorten total oxygen therapy time.2.NHFOV does not increase the incidence of complications and is a relatively safe and effective non-invasive ventilation mode.