A Prospective Rct:The Security And Efficacy Of Nasal Continuous Positive Airway Pressure(NCPAP) As Continuous Treatment After Synchronize Nasal Intermittent Positive Pressure Ventilation(SNIPPV) Of Premature Neonates With Respiratory Distress Syndrome AS

Objective To investigate the clinical efficacy and prognosis of synchronized nasal intermittent positive pressure ventilation(SNIPPV)continuous nasal continuous positive airway pressure(NCPAP)in the stage of weaning of RDS preterm infants with respiratory distress syndrome(RDS).Methods From October 2017 to October 2018,choose 120 neonates from neonatal intensive care units(NICU)of three tertiary hospitals,whose gestational age <32weeks,weight less than 1500 g,and these premature infants with severe RDS all requiring mechanical ventilation.After evacuation of mechanical ventilation,patients were divided into three groups according to the random number method: SNIPPV group,NCPAP group and SNIPPV continuous NCPAP treatment group.Collect basic information about the three groups of children,and observe the clinical symptoms of them.All the children were counted the following indicators: intubation rate within 72 hours after extubation,non-invasive ventilation success rate within one week after extubation,non-invasive ventilation time,total oxygen therapy time,total intestinal feeding time,the incidence of adverse complications(such as patent ductus arteriosus(PDA),bronchopulmonary development(bronchopulmonary dysplasia(BPD),retinopathy of prematurity(ROP),neonatal brain injury et al.),hospitalization time,hospitalization expenses and so on.Results 1.There were no statistical differences in the basic conditions during three groups(like gestational age,birth weight,mode of delivery,premature rupture of membranes,twins,pulmonary surfactant use and mechanical ventilation time).2.The failure rate of extubation between the NCPAP group,SNIPPV group and continuous treatment group was 25%,5% and 5%.The successful rate of weaning non-invasive ventilation within one week after extubation between the NCPAP group,SNIPPV group and continuous treatment group were: 40%,70% and 75%;The efficacy of assisted extubation in the SNIPPV group and the continuous treatment group was significantly better than that in the NCPAP group(P<0.05).3.There was no significant difference in the comparison between three groups of the following indicators:non-invasive ventilation time,total oxygen therapy time,hospitalization time and cost,complications(neonatal brain injury,neonatal pneumonia,neonatal feeding intolerance,ROP,BPD,PDA)incidence,reaching total intestinal feeding time,feeding time and and so on(P>0.05).Conclusions SNIPPV continuous NCPAP mode after mechanical ventilation in severe RDS preterm infants is a relatively safe and effective ventilation method,but it still needs large-sample,multi-center clinical trials.