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

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.