Investigate various strategies for weaning nasal continuous positive airway pressure (NCPAP) in premature neonates with respiratory distress syndrome

Abstract

Most of the worldwide studies on different methods of separating infants from respiratory support with positive airway pressure have not reached a consensus on this issue and many complications have been imposed on infants. Respiratory positive airway pressure and the possibility of failure of the airway separation process and the need to re-apply positive airway pressure and the risks of this failure and the possibility of oxygen poisoning, premature retinopathy and intraventricular hemorrhage in these infants, we decided to study Let's do this in our country. Therefore, the aim of this study was to compare different strategies to discontinue positive airway pressure (NCPAP) in preterm infants with respiratory distress syndrome. Materials and Methods: This study was a randomized clinical trial without blindness that was performed during 2019-2020 with the participation of 75 premature infants aged 26 to 32 weeks with respiratory distress syndrome born in Alzahra Hospital in Tabriz. Patients were randomly divided into four groups. The first group, with a positive airway pressure of 5 and an oxygen deficit of 30%, abruptly stopped breathing and the infants underwent respiratory support with HFNC at a rate of 3 liters per minute and an oxygen deficit of 30%. The second group gradually decreases every 8 hours 1 cm of positive airway pressure (PEEP) water with positive airway pressure reaching 3 and oxygen consumption to 25% neonates with respiratory support with 3 HFNC liters per minute and oxygen fraction 25% Placed. The third group gradually decreases 1 cm of positive airway pressure (PEEP) every 8 hours, and with the positive airway pressure reaching 3 and oxygen consumption to 25% of neonates under respiratory support with an oxygen hood of 5-6 liters per minute and oxygen fraction Consumption is 30%. Results: The improvement rate of the three groups in terms of respiratory score indicated that the most changes in the HFNC-30 group (P = 0.001), then the HFNC-25 group (P=0.014) and then in the OXY HOOD group (0.029). 0 = P) was observed. The mean duration of hospitalization after the intervention also showed that there was no statistically significant difference between the three groups (P = 0.096). Also, in none of the groups was there a need to increase FIO2 by 10%. ROP required intervention in 4 neonates of Oxy Hood group, in 2 neonates of HFNC-25 group and in one neonate of HFNC-30 group, the comparison of the results of the three groups was significantly different (P = 0.048). All cases of respiratory distress syndrome were associated with complete recovery, which indicates that all three methods of intervention have been effective in improving this complication.