Clinical Study Of Nasal BiPAP Support In Premature Infants With RDS

Objective:To evaluate the effect and possible complications of nasal bi-level positive airway pressure ventilation(Bi PAP)in the treatment of preterm infants with respiratory distress syndrome.Methods:Sixty premature infants with RDS were collected in our study.The infants had accepted pulmonary surfactant(PS)treatment divided into early preterm infants group(n=24)and late preterm infants group(n=36)according to gestational age,each group of patients were randomly supported with nasal Bi PAP or nasal continuous positive airway pressure(n CPAP),then the supported infants divided into two groups of nasal Bi PAP and n CPAP.The arterial blood gas analysis,time of non invasive ventilation and oxygen therapy,re-intubation rate and non invasive ventilation complications were compared between the nasal Bi PAP and n CPAP groups in the early and late preterm infants groups.Results:The PH were no significant difference(P>0.05)after supported at 12 h,24h and 48 h with nasal Bi PAP or n CPAP of early preterm infants group and late preterm infants group.The Pa O2 at 24 h was higher in nasal Bi PAP group than n CPAP group(P=0.02),however,the Pa O2 at 12 h and 48 h had no significant difference(P>0.05),in early preterm infants groups.The Pa O2 were all higher in Bi PAP group than n CPAP group(P<0.01)at 12 h,24h,and 48 h in early preterm infants groups.The Pa CO2 were all lower(P<0.01)in nasal Bi PAP group after supported at 12 h,24h and 48 h of early preterm infants group and late preterm infants group.The OI had no statistical difference(P>0.05)after supported at 12 h,24h and 48 h with nasal Bi PAP or n CPAP of early preterm infants group,with nasal Bi PAP the OI higher than n CPAP at 12 h,24h and 48 h of late preterm infants group(P<0.01).Time of noninvasive ventilation and intubation rate had no significant difference(P>0.05)with nasal Bi PAP or n CPAP of all the infants,duration of oxygen therapy of nasal Bi PAP group shorter than n CPAP group(P=0.03)in late preterm infants group,however,in early preterm infants group had no significant difference(P>0.05).Total enteral feeding time and length of stay had no statistical difference(P>0.05)in early preterm infants,length of stay also had no statistical difference(P>0.05)in late preterm infants,but the total enteral feeding time was leader with nasal Bi PAP(P=0.02).The incidence of VAP had no statistical difference(P>0.05)in two groups of early and late preterm infants.No pneumothorax,BPD,NEC,PIVH occurred in our study.Conclusion:(1)For early preterm infants,nasal Bi PAP can significantly improving CO2 retention,while in the improvement of Pa O2 and OI,Bi PAP may not be superior than n CPAP.(2)Compared with n CPAP,nasal Bi PAP can significantly improving the Pa O2,Pa CO2 and OI of late preterm infants with RDS.