A multicenter randomized controlled trial comparing effectiveness of two nasal continuous positive airway pressure devices in very-low-birth-weight infants
| Autor: | Elzbieta Gajewska, Grzegorz Zieliński, Thomas E. Bachman, Janusz Witalis, Jakub Behrendt, Wojciech Walas, Małgorzata Czyzewska, Agnieszka Turzańska, K Bober, Beata Czeszyńska, Janusz Świetliński, Jan E Zejda, Piotr Korbal, Dorota Pawlik, Maria Wilińska, Katarzyna Kornacka |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_treatment Birth weight Critical Care and Intensive Care Medicine Positive airway pressure medicine Humans Infant Very Low Birth Weight Continuous positive airway pressure Prospective Studies Mechanical ventilation Respiratory Distress Syndrome Newborn Respiratory distress Continuous Positive Airway Pressure business.industry Infant Newborn Gestational age Equipment Design respiratory system medicine.disease Low birth weight Treatment Outcome Anesthesia Pediatrics Perinatology and Child Health Necrotizing enterocolitis Female Poland medicine.symptom business Infant Premature |
| Zdroj: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 13(2) |
| ISSN: | 1529-7535 |
| Popis: | OBJECTIVE Many studies suggest nasal continuous positive airway pressure is an effective and relatively complication-free means of respiratory support in premature infants. However, only limited data exist regarding the practical aspects of nasal continuous positive airway pressure delivery, including the best way to provide the positive airway pressure. DESIGN Our aim was to compare the results of treatment using two different nasal continuous positive airway pressure devices: variable flow Infant Flow and constant flow nasal continuous positive airway pressure in two different groups of very-low-birth-weight infants in a multicenter randomized controlled trial. The indication groups were elective to avoid intubation and weaning from mechanical ventilation. SETTING Twelve leading tertiary care neonatal centers in Poland. PATIENTS Among 276 infants (weighing between 750-1500g, with a gestational age ≤32 wks) enrolled, 51% were randomized to receive Infant Flow and 49% to receive constant flow nasal continuous positive airway pressure. MEASUREMENTS AND MAIN RESULTS Treatment success (i.e., no need for intubation/reintubation) occurred in 75% of our patients with a nonstatistically significant advantage seen with Infant Flow. The incidence of severe nasal complications and necrotizing enterocolitis were statistically significantly lower in the infants treated with Infant Flow. In our study, factors associated with elective nasal continuous positive airway pressure failure were birth weight ≤1000 g, gestational age ≤28 wks, clinical risk index for babies score >1, and PaO(2)/FIO(2) ratio of |
| Databáze: | OpenAIRE |
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