The Effect Of The Treatment With Heated Humidified High Flow Nasal Cannula In Premature Infant Respiratory Distress Syndrome

ObjectivesTo investigate the effect and safety of heated humidified high flow nasal cannula(HH FNC)in the initial treatment of premature infant respiratory distress syndrome(RDS).Method1.One hundred and twenty-nine infants who meet the inclusion criteria and were diagnosed with neonatal respiratory distress syndrome spelling to our neonatal intensive care unit(NICU)from Mar.2017 to Dec.2018 were recruited.They were randomly assignned to HHHFNC group(65 cases)and nasal continuous positive airway pressure(NCPAP)group(64 cases).During our clinical trial,3 neonates’treatments were abandoned at the request of their parents(2 cases of HHHFNC group,lcase of NCPAP group),and 1 neonate died(1 case of HHHFNC group).A total of 125 neonates completed this trial.2.Then they were assigned to A group and B group during the healing process according to their X-ray chest films and FiO2.A group:the X-ray chest films showed gradeⅠ-Ⅲ RDS and FiO2≤0.4.B group:X-ray chest films showed grade Ⅳ RDS or FiO2>0.4.The therapeutic effect and complication ratio were compared between two groups.3.The statistics software SPSS 22.0 is used for data processing.The tested data are verified to see whether they are normally distributed and the observation indexes are indicated as X±S,if not,we used the Mann-Whitney U test.T-test or Mann-Whitney U test and χ2 test had been adopted.If P<0.05,we say that they have very differences.If P<0.01,we say they have very significant differences.Result1.A group(42 infants of HHHFNC group and 39 infants of NCPAP group):There was 1 case had nasal damage in HHHFNC group,and 8 cases in NCPAP group.The incidence of nasal damage(2.38%VS 20.51%,χ2=6.731 P=0.009)was significantly lower in the HHHFNC group than in the NCPAP group.The incidence of abdominal distension(4.76%VS 20.51%,χ2=4.636 P=0.031)was significantly lower in the HHHFNC group than in the NCPAP group.There were no differences in the other respiratory and clinical outcomes between the two groups(P>0.05).2.B group(20 infants of HHHFNC group and 24 infants of NCPAP group):There was 8 cases had the intubation again in HHHFNC group,and 3 cases in NCPAP group.The incidence of reintubation(40.00%VS 12.50%,χ2=4.400 P=0.036)was lower in the HHHFNC group than in the NCPAP group.The babies of HHHFNC group have long times of noninvasive ventilation than The babies of NCPAP group(t test shows p=0.032).The babies of HHHFNC group have long times of hospital stays than The babies of NCPAP group(Mann-Whitney U test shows p=0.016).There was 0 case had nasal damage in HHHFNC group,and 6 cases in NCPAP group.The incidence of nasal damage(give Fisher test,P=0.025)was significantly lower in the HHHFNC group than in the NCPAP group.There were no differences in the other respiratory and clinical outcomes between the two groups(P>0.05).Conclusion1.HHHFNC has the same effect and higher security than NCPAP in the initial treatment of mild-to-moderate neonatal RDS.2.HHHFNC has the lower effect but higher security than NCPAP in the initial treatment of severe neonatal RDS.3.For the entire,HHHFNC is a priority selection for mild-to-moderate neonatal RDS,but should be carefully selected as the initial treatment for severe neonatal RDS.