Comparison Of Respiratory Mechanics And Extubation Effect Of Different Maintenance Doses Of Caffeine Citrate In Premature Infants During Peri-extubation Period

Objective: To explore the effects of different maintenance doses of caffeine citrate on respiratory mechanics and extubation effect in preterm infants during extubation.Methods: Ninety premature infants with mechanical ventilation lasting more than 2days and gestational age less than 35 weeks in Putian Children's Hospital from 2016 to 2018 were selected as the study subjects.In the treatment,three groups were divided into 5 mg maintenance dose of caffeine citrate and 10 mg maintenance dose of caffeine citrate and conventional treatment.The number of patients in each group was 30,with 5 mg caffeine citrate respectively.In the enkephalin group,10 mg caffeine citrate group and routine treatment group,breathing and parameters before and before extubation,blood gas analysis indexes 2 hours before and 2 hours after extubation,changes of respiratory mechanics indexes before and before treatment,and changes of blood gas indexes before and after extubation,patients were required in the study.The ventilation mode,successful rate of extubation and adverse reactions after extubation were compared and analyzed.Result: There was no significant difference in ventilator parameters between the three groups 2 hours before treatment with caffeine citrate.After 2 hours of treatment with caffeine citrate at the corresponding maintenance dose,the indexes of premature infants in the 10 mg caffeine citrate group were significantly better than those in the 5mg caffeine citrate group and the routine treatment group,of which the 5 mg caffeinecitrate group was earlier than those in the 5 mg caffeine citrate group.The index of delivery was better than that of routine treatment group;the success rate of extubation was the highest in 10 mg caffeine citrate group,followed by 5 mg caffeine citrate group and the lowest in routine treatment group;the respiratory function and airway resistance of premature infants in 10 mg caffeine citrate group were the lowest,followed by 5 mg caffeine citrate group and the highest in routine treatment group;and the respiration rate of premature infants in 10 mg caffeine citrate group was the lowest.The values of work absorption and airway resistance were the highest,followed by 5 mg caffeine citrate group and the lowest in routine treatment group;10mg caffeine citrate group had the least number of cases requiring mechanical ventilation,the shortest time;5 mg caffeine citrate group had the second highest number of cases and the longest time;10 mg caffeine citrate group had the longest blood gas analysis of premature infants.Indicators were better than the other two groups;the increase of partial pressure of oxygen and partial pressure of carbon dioxide in 10 mg caffeine citrate group was greater than that in 5 mg caffeine citrate group and routine treatment group;the incidence of adverse reactions in 10 mg caffeine citrate group was higher than that in the other two groups,and the incidence of adverse reactions in routine treatment group was the lowest,and feeding intolerance in this group was intolerant.The occurrence of adverse reactions was abnormal.Conclusion: Caffeine citrate at a sustained dose of 10 mg for preterm infants has a good effect on respiratory mechanics index and extubation effect during peri-extubation period.It can greatly improve the success rate of extubation and should be widely used in clinic.