Clinical trial and effect of Bi-level continuous positive airway pressure on early  pulmonary function in preterm infants with mild respiratory distress syndrome

ZHANG Hui-jie; WEN Xiao-hong; HUANG Hui-zhi; PAN Jun-ping; SHEN Pei-ting; WU Wan-yun

doi:10.11852/zgetbjzz2018-0332

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Chinese Journal of Child Health Care ›› 2019, Vol. 27 ›› Issue (2) : 197-201. DOI: 10.11852/zgetbjzz2018-0332

Clinical trial and effect of Bi-level continuous positive airway pressure on early pulmonary function in preterm infants with mild respiratory distress syndrome

ZHANG Hui-jie, WEN Xiao-hong, HUANG Hui-zhi, PAN Jun-ping, SHEN Pei-ting, WU Wan-yun

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Abstract

Objective To explore the efficacy and effect of Bi-level continuous positive airway pressure (BiPAP) on early pulmonary function in the treatment of premature infants with mild respiratory distress syndrome (RDS). Methods Totally 76 preterm infants with mild RDS in Neonatal Intensive Care Unit (NICU) of the Third Affiliated Hospital of Anhui Medical University were selected as participants from June 2016 to January 2018 and given non-invasive ventilation after birth. The infants were randomly divided into BiPAP group(38 cases) and CPAP group (38 cases). The therapeutic effect and early pulmonary function of the two groups were compared. Results 1) The endotracheal intubation rate of the BiPAP group was significantly lower than that of the CPAP group(5.26% vs. 26.32%, P<0.05),but the average duration for noninvasive respiratory support ,the average time of complementary oxygen need, repeated application of pulmonary surfactant, other complications, the death rate and the average hospitalization days between the two groups were not significantly different (P>0.05). 2) The BiPAP group had significantly lower respiratory rate[(42.98±4.26)times/min vs. (46.13±4.58)times/min], higher tidal volume[(6.50±1.29)ml/kg vs. (5.55±1.03)ml/kg] and minute ventilation [(0.50±0.66)L/(min·kg) vs. (0.45±0.47)L/(min·kg)]( P<0.05), while the differences on the ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume to peak tidal expiratory flow to total expiratory volume, peak expiratory flow, and breathing flow at 75%, 50%, and 25% of tidal volume were not significant in both groups (P>0.05) . Conclusion Compared with CPAP, BiPAP is safer and more effective in the treatment of mild RDS in preterm infants, and can also improve lung compliance and early lung function in preterm infants with RDS.

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Bi-level continuous positive airway pressure / continuous positive airway pressure / respiratory distress syndrome / pulmonary function / preterm infants

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ZHANG Hui-jie, WEN Xiao-hong, HUANG Hui-zhi, PAN Jun-ping, SHEN Pei-ting, WU Wan-yun. Clinical trial and effect of Bi-level continuous positive airway pressure on early pulmonary function in preterm infants with mild respiratory distress syndrome[J]. Chinese Journal of Child Health Care. 2019, 27(2): 197-201 https://doi.org/10.11852/zgetbjzz2018-0332

References

[1] DiBlasi RM. Neonatal noninvasive ventilation techniques:do we really need to intubate? [J].Respiratory Care,2011,56(9):1295-1297.
[2] Jeon GW. Respiratory support with heated humidified high flow nasal cannula in preterm infants [J]. Korean Pediatr,2016,59(10):389-394.
[3] Schmzer GM, Kumar M, Pichler G,et al. Non-invasive versus invasive respiratory support in preterm infants at birth:systematic review and meta-analysis [J]. BMJ,2013,347:f5980.
[4] Fischer HS, Bührer C.Avoiding endotracheal ventilation to prevent bronchopulmonary dysplasia a meta-analysis [J]. Pediatrics,2013,132(5):e1351-e41360.
[5] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4 版.北京:人民卫生出版社,2011:395-397.
[6] Sadeghnia A, Barekateyn B, Badiei Z, et al. Analysis and comparison of the effects of N-BiPAP and in Bubble-CPAP treatment of preterm newborns with the weight of below 1500 grams affiliated with respiratory distress syndrome:a randomised clinical trial[J]. Adv Biomed Res,2016,5:3.
[7] Migliori C, Motta M, Angeli A, et al. Nasal bilevel vs. continuous positive airway pressure in preterm infants[J]. Pediatr Pulmonol,2005, 40(5):426-430.
[8] Salvo V, Lista G, Lupo E,et al.Noninvasive ventilation strategies for early treatment of RDS in preterm infants:an RCT [J]. Pediatrics,2015,135(3):444-451.
[9] 中华医学会儿科学分会呼吸学组肺功能协作组. 儿童肺功能系列指南(四):潮气呼吸肺功能[J]. 中华实用儿科临床杂志,2016, 31(21):1617-1621.
[10] Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome-2016 update[J]. Neonatology,2017,111:107-125.
[11] Rojas MA, Lozano JM, Rojas MX, et al. Very early surfactant without mandatory ventilation in premature infants treated with early continuous positive airway pressure:a randomized, controlled trial[J]. Pediatrics,2009, 123(1):137-142.
[12] Kieran EA, Walsh H, O′Donnell CPF. Survey of nasal continuous positive airways pressure(NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) use in Irish newborn nurseries [J].Arch Dis Child Fetal Neonatal Ed,2011,96:F156.
[13] Morley SL. Non-invasive ventilation in paediatric critical care.[J]. Paediatr Respir Rev,2016,20:24-31.
[14] Lista G, Castoldi F, Fontana P, et al. Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome:a randomised control trial[J]. Arch Dis Child Fetal Neonatal Ed,2010, 95(2):85-89.
[15] O′ Brien K, Campbell C, Brown L, et al.Infant flow biphasic nasal continuous positive airway pressure (BP-NCPAP) vsinfant flow NCPAP for the facilitation of extubation in infants′≤1250 grams:a randomized controlled trial[J].BMC Pediatr,2012,12:43.
[16] 戴立英, 张健, 王琍琍. 双水平正压通气在早产儿呼吸窘迫综合征治疗中的应用[J]. 临床儿科杂志,2014,32(8):732-735.
[17] 林报忠, 郑通喜, 蒋波,等. 肺表面活性物质联合双水平气道正压通气治疗新生儿呼吸窘迫综合征的临床疗效[J]. 实用心脑肺血管病杂志,2017,25(7):77-80.
[18] Aguiar T, Macedo I, Voutsen O, et al. Nasal bilevel versus continuous positive airway pressure in preterm infants:a randomized controlled trial [J].Journal Clinical Trials,2015,5:3.
[19] Ricotti A, Salvo V, Zimmermann LJI, et al.N-SIPPV versus bi-level N-CPAP for early treatment of respiratory distress syndrome in preterm infants[J].Matern Fetal Neonatal Med,2013,26(13):1346-1351.
[20] Mphil DMG, Mcur LW, Btech AA, et al. Lung function in African infants: a pilot study[J]. Pediatric Pulmonology,2015,50(1):49-54.
[21] Nguyen TT, Hoo AF, Lum S, et al. New reference equations to improve interpretation of infant lung function[J]. Pediatric Pulmonology,2013,48(4):370-380.
[22] Vrijlandt EJ, Kerstjens JM, Duiverman EJ, et al. Moderately preterm children have more respiratory problems during their first 5 years of life than children born full term[J]. Am J Pespir Crit Care Med,2013,187(11):1234-1240.
[23] 朱洪斌, 高彩云, 闫爱霞,等. nBiPAP和nCPAP治疗早产儿呼吸暂停疗效比较及对患儿肺功能和Gesell评分的影响[J]. 临床肺科杂志,2018,23(1):73-78.
[24] Ishihara C,Ibara S, Ohsone Y, et al. Effects of infant flow Bi-NCPAP on apnea of prematurity [J]. Pediatr Int,2016,58(6):456-460.
[25] Lampland AL, Plumm B, Worwa C, et al. Bi-level CPAP does not improve gas exchange when compared with conventional CPAP for the treatment of neonates recovering from respiratory distress syndrome[J]. Arch Dis Child Fetal Neonatal Ed,2015,100(1):F31-F34.