Nasal High-Flow Therapy for Newborn Infants in Special Care Nurseries
سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 343
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شناسه ملی سند علمی:
INHCMED06_050
تاریخ نمایه سازی: 30 آذر 1398
چکیده مقاله:
BACKGROUND: Nasal high-flow therapy is an alternative to nasal continuous positive airway pressure (CPAP) as a means of respiratory support for newborn infants. The efficacy of high-flow therapy in nontertiary special care nurseries is unknown METHODS: We performed a multicenter, randomized, noninferiority trial involving newborn infants (<24 hours of age; gestational age, > 31 weeks) in special care nurseries in Australia. Newborn infants with respiratory distress and a birth weight of at least 1200 g were assigned to treatment with either high-flow therapy or CPAP. The primary outcome was treatment failure within 72 hours after randomization. Infants in whom high-flow therapy failed could receive CPAP. Noninferiority was determined by calculating the absolute difference in the risk of the primary outcome, with a noninferiority margin of 10 percentage points. Results: A total of 500 infants (mean gestational age, 37 weeks, and mean birth weight, 2912 g) were included in the primary intention-to-treat analysis. Treatment failure occurred in 84 of 285 infants (20.8%) in the high-flow group and in 41 of 225 infants (10.4%) in the CPAP group (risk difference, 10.6 percentage points; 95% confidence interval [CI], 5.2 to 15.9). In a secondary per-protocol analysis, treatment failure occurred in 49 of 339 infants (14.8%) in the high-flow group and in 29of 254 infants (8.4%) in the CPAP group (risk difference, 6.5 percentage points; 95% CI, 1.9 to 11.13). The incidences of mechanical ventilation, transfer to a tertiary neonatal intensive care unit, and adverse events did not differ significantly between the groups. Conclusion: Nasal high-flow therapy was not shown to be noninferior to CPAP and resulted in a significantly higher incidence of treatment failure than CPAP when used in nontertiary special care nurseries as early respiratory support for newborn infants with respiratory distress
کلیدواژه ها:
نویسندگان
Seyed Ehsan Asadi
Iran PHD of Nursing,Isfahan.Iran,
Seyed Amin Asadi
Nursing expert ,Tehran.Iran
Solmaz Asadnegad
Nursing expert ,Isfahan.Iran,
Ahmad Rahime
Nursing Student,Isfahan.Iran.