A Comparative Study Of The Effectiveness And Safety Of Two Non-invasive Ventilation Modes In Treatment Of Neonatal Respiratory Distress Syndrome After Extubation

Objective:To compare the effectiveness and safety of non-invasive high-frequency oscillatory ventilation?nHFOV?and non-bilevel positive airway pressure?nBiPAP?in treatment of neonatal respiratory distress syndrome?RDS?after extubation.Methods:A total of 68 cases of neonates with moderate or severe RDS in NICU who were hospitalized from January 2018 to December 2019 of the First Affiliated Hospital of Xinjiang Medical University were included in this study.An hour before removing invasive ventilation,it was randomly divided into nHFOV group?observation group?and nBiPAP group?control group?.There were 33 cases in nHFOV group and 35 cases in nBiPAP group.Except for the respiratory support method,the other treatments remained the same.Non-invasive respiratory support with carbon dioxide partial pressure?PaC0₂?,oxygen partial pressure?PaO₂?at 6 to 24hours after extubation,reintubation rate for non-invasive support failure within 7 days,length of hospital stay and the incidence of complications of two groups have been observed.Results:1)At 6-24hours of noninvasive ventilation in two groups of children,the oxygen partial pressure?PaO₂?of the two groups was compared.The nHFOV group>nBiPAP group[?89.36±23.22?mmHg ratio?76.29±17.10?mmHg]?P<0.05?.the difference was statistically significant.Comparing the carbon dioxide partial pressure?PaCO2?between the two groups,the nHFOV grouP<nBiPAP group[?31.39±5.74?mmHg ratio?41.83±10.10?mmHg]?P<0.05?,the difference was statistically significant.Comparing the oxygenation index?OI?between the two groups,nHFOV group>nBiPAP group[?265.14±88.48?mmHg ratio?219.21±74.52?mmHg]?P<0.05?,the differences are statistically significant.There was no difference in PH between the two groups?P>0.05?;2)Compared with nBiPAP group,the nHFOV group had a lower rate of non-invasive failure and re-intubation after weaning,and the difference was statistically significant?7/33 vs.16/35,P<0.05?;3)The non-invasive ventilation time in the nHFOV group was shorter than that in the nBiPAP group,[?5.97±4.71?days compared to?13.17±12.52?days,P<0.05];4)The length of hospital stay in the nHFOV group was shorter than that in the nBiPAP group[?22.39±11.45?days than?34.66±18.89?days,P<0.05];5)There were no significant differences in the incidence of complications such as pneumothorax,intracranial hemorrhage,bloating,nasal constriction,ROP,NEC,HsPDA,and apnea,except for BPD at 28 days after birth in the two groups.0.05).Conclusions:Both two groups have a good effect in the treatment of preterm RDS.But compared with nBiPAP,nHFOV can effectively reduce the partial pressure of carbon dioxide,improve oxygenation and enhance the partial pressure of oxygen as well as the treatment success rate.It may be a new tape of safe and efficient non-invasive ventilation mode by reducing the time of non-invasive ventilation,the rate of reintubation,the length of hospital stay in the NICU and the occurrence of BPD,with no other complications increased.