Discussion And Evaluation Of The Application Range Of NCPAP In Critically Ill Children

Objective: At home and abroad about the clinical use of nasal continuous positive airway pressure?Nasal Continuous Positive Airway Pressure, NCPAP? range of specific applications are still being explored.Based on our hospital PICU NCPAP clinical analysis of children, this study clear NCPAP application value in pediatrics PICU, and explore application range of NCPAP in critically ill children.Methods: A prospective study was collected in May 2014--2015 Check in October hospital PICU shortness of breath NCPAP instead of 192 cases of children with severe clinical data still exists in the nasal cannula oxygen after 1 hour, including when to start using NCPAP? 0 hours?, the use of 1 hour, 4 hours after the basic vital signs at each time point?heart rate, respiration, body temperature, blood pressure?, blood gas analysis?partial pressure of oxygen, carbon dioxide partial pressure, PaO₂ / FiO₂?index, shortness of breath, wheezing, moaning, nasal flaring, three depressions and NCPAP parameters?PEEP, FiO₂, gas flow rate? and other clinical data. Comparison of clinical data using various time points before and after NCPAP, assess the clinical effect of NCPAP. According to another use NCPAP oxygen partial pressure were divided into group A?group shortness of breath?PaO₂ ? 70 mm Hg??, group B?shortness of breath, reduced oxygen partial pressure combined group?50mm Hg<PaO₂ <70mm Hg??, C group?shortness of breath merger failure group?PaO₂ ? 50 mm Hg?? three groups to compare three groups of children at different time points of the indicators of change, a clear clinical effect of NCPAP. Comparison of the three groups using NCPAP long, length of stay, live PICU time, non-invasive ventilation failure, discharged, the preliminary study of critically ill children to use NCPAP range of applications. Count data using ? 2 test, using the mean plus or minus standard deviation, variance missing or non-normal distribution, the median and interquartile range M?P25P75?, said rows normal parameter measurement data and homogeneity of variance Kruskal-wallis non-parametric test was statistically significant between the lines when multiple samples pairwise comparisons; with p <0.05, the difference was considered statistically significant.Results:1.192 cases of critically ill children, the male 119 cases?61.93%?, female73 cases?38.02%?, aged 1 month to 6 years and 11 months. A group of 56patients?29.2%? in group B 81 cases?42.2%? in group C 55 cases?28.6%?, after the arrival of PICU, three groups of children PCIS score was?81.14 � 5.16,77.11 � 7.11, respectively, within 24 hours, 74.73� 6.38, F = 14.439, p = 0.00?, the three groups difference was statistically significant.2. comparison of 192 cases of critically ill children with shortness of breath, heart rate, oxygen partial pressure, PaO₂ / FiO₂, wheezing,moaning, nasal flaring, three depressions use NCPAP 0 hours, using NCPAP1 hours, using NCPAP4 hours, there were statistically significant?P <0.05?.3, group A non-invasive ventilation failure in 2 cases?3.57%?, group B noninvasive ventilation failure in 9 cases?11.11%? in group C of noninvasive ventilation failure 30 cases?54.55%?, A, B, C three groups of non-invasive ventilation failure was statistically significant?P <0.05?.4, A, B, C three groups of children with long?hours? when using NCPAP were?122.57 � 60.83,123.82 � 62.71,92.18 � 63.25, F =2.43, p = 0.042?. A, B, C three groups of children live PICU time?days?respectively?11.77 � 6.94,12.14 � 8.45,15.60 � 9.64, F = 3.653, p= 0.028?, three groups of children hospitalized days were?12.54 �7.05,13.28 � 10.7,18.55 � 10.53, F = 6.801, p = 0.00?.compare to time length of using NCPAP, number of PICU days and hospitalization days, there is no significant differences between the two group A and B?P> 0.05?; group C and A, B two groups was significantly different?P<0.05?.5, Comparison of three groups of patients discharged from hospital,In group A, 24 cases were cured, 32 were improved and uncured in 0 cas e; In group B, 19 cases were cured, 53 were improved and 9 were healed;In group C, 9 cases were cured, 31 were improved and 15 were healed;Comparison of the three groups of discharge situation, there were statistical differences.?c2= 25.19, p = 0.00?Conclusion:1, NCPAP has obvious effect on the critically ill children with conventional oxygen remains respiratory abnormalities.2, NCPAP can improve work of breathing to critically ill children with breathing difficulties.3, Children with respiratory failure under nasal catheter are easily cause the failure of noninvasive assisted ventilation in the use of NCPAP assisted ventilation, In the process of useing, closely monitor of the disease condition are needed.Easy to cause the failure of noninvasive assisted ventilation...