Introduction of Infant Flow nasal continuous airway pressure as the standard of practice in Poland: The initial 2-year experience
| Autor: | Jerzy Szczapa, Bohdan Maruszewski, Małgorzata Manowska, Ewa Helwich, Elzbieta Gajewska, Lech Hubicki, Janusz Swietliński, Klaudiusz Bober, Ryszard Lauterbach |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Positive-Pressure Respiration Clinical endpoint Humans Medicine Prospective Studies Prospective cohort study Mechanical ventilation Analysis of Variance business.industry Tracheal intubation Infant Newborn medicine.disease Treatment Outcome Respiratory failure Pneumothorax Practice Guidelines as Topic Pediatrics Perinatology and Child Health Etiology Female Poland Respiratory Insufficiency business Airway |
| Zdroj: | Pediatric Critical Care Medicine. 8:109-114 |
| ISSN: | 1529-7535 |
| Popis: | Objective The aim of this prospective study was to evaluate whether a change in the standard of newborn care for respiratory insufficiency by widely introducing more aggressive use of nasal continuous airway pressure (nCPAP) and including Infant Flow technology would result in satisfactory outcomes. Design Prospectively defined analysis. Setting Fifty-seven secondary and tertiary care neonatal centers in Poland. Patients Patients were 1,299 newborns. Interventions None. Measurements and main results We carried out a prospectively defined analysis of 1,299 newborns included in the program between August 1, 2003, and April 30, 2005. The inclusion criterion was the occurrence of symptoms of respiratory failure irrespective of its etiology. Respiratory support was provided with the use of the Infant Flow Advance Driver. The analysis was made on data from prospectively designed questionnaires completed following each infant's treatment. Infants were placed into categories based on clinical indication for use. The primary end point was avoiding tracheal intubation. A high rate of acceptance of the new practice was observed across the substantial demographic and clinical diversity of newborns. Tracheal intubation was avoided in 78% of infants treated electively with nCPAP. Of those being weaned from mechanical ventilation, 61.2% were successfully weaned. Related complications were low (1.4% pneumothorax, 12% nasal injuries). Conclusions The new method of nCPAP with Infant Flow was adopted as standard practice in Poland. We monitored its safety and effectiveness over a 2-yr period and found it to be safe and effective as implemented. Additional research is still needed to determine the optimum patient population, strategy for use, and devices. |
| Databáze: | OpenAIRE |
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