Safety Of Two Different Weaning Strategies After High-frequency Oscillatory Ventilation In Preterm Infants With Respiratory Distress Syndrome:a Prospective Randomized Controlled Trial

Objective:To investigate the safety of two ventilator weaning strategies after high-frequency oscillatory ventilation(HFOV)for the treatment of neonatal respiratory distress syndrome(NRDS)in preterm infants.Methods:A prospective randomized controlled trial(January 2019 to June 2020)was conducted in Xiamen Maternal and Child Health Hospital.And it was registered at Chinese Clinical Trial Registry(ChiCTR2000038281).Preterm infants≤32+6 weeks or birth weight≤1500g requiring invasive ventilation with respiratory distress syndrome were enrolled.A total of 101 infants were randomly divided into weaning from HFOV diretly group(observation group,n=50)and switching and subsequent weaning and extubating from CMV group(control group,n=51).The primary outcme was the failure rate of extubation within 72 hours.The secondary outcomes were changes in blood gas parameters before and after extubation,the parameters of respiratory support treatment and the incidence rates of complications and outcome between the two groups at discharge.Results:The failure rate of extubation within 72 hours in observation group was 8%,which was slightly lower when compared with control group 14%,but there was no significant difference between the two groups(P>0.05).The invasive mechanical ventilation time in observation group was significantly shorter(63.6±39.3h VS 87.9±69.4h,P<0.05).There was no significant difference in duration of mechanical ventilation and total oxygen supply time,blood gas parameters before and after ventilator weaning,incidence rates of complications,and outcome at discharge(P>0.05).Conclusion:For premature infants with NRDS,the strategy of weaning directly from HFOV is a safe and effective clinical option,which can reduce the invasive mechanical ventilation time,and worthy to be clinically popularized and applied.