A Clinical Trial And Effect On Early Lung Function Of Bi-Level Continuous Positive Airway Pressure In Preterm Infants With Neonatal Respiratory Distress Syndrome

Objective By comparing with the traditional noninvasive ventilation mode—continuous positive airway pressure(CPAP),to explore the efficacy and effect on early lung function of Bi-level continuous positive airway pressure(BiPAP)in the treatment of premature infants with neonatal respiratory distress syndrome(NRDS).Methods According to the inclusion criteria and exclusion criteria of the research design,76 preterm infants with NRDS who were admitted to neonatal intensive care unit(NICU)of Third Affiliated Hospital of Anhui Medical University were selected as the subjects from June 2016 to January 2018,and given non-invasive ventilation after birth.They were divided into BiPAP group(38 cases)and CPAP group(38 cases)by random number method.There was no significant difference in the general condition(gender,gestational age,birth weight,1 minute Apgar score,5 minutes Apgar score,age,antenatal glucocorticoid treatment,mother with gestational diabetes)between the two groups.The study mainly observes the following three aspects:(1)By comparing the average duration for noninvasive respiratory support,the average time of need to complementary oxygen,application of pulmonary surfactant,endotracheal intubation rate,the death rate and average length of hospital stay,to compare whether there is a difference in the clinical efficacy of two noninvasive ventilation modes in the treatment of NRDS in preterm infants.(2)By comparing the incidence of various complications(apnea of premature,patent ductus arteriosus,intraventricular hemorrhage,bronchopulmonary dysplasia(BPD)and pneumothorax),to compare whether there is a difference in the safety of two noninvasive ventilation modes in the treatment of NRDS in preterm infants.(3)The tidal breathing lung function tests were performed at 36 weeks after the correction of gestational age,and the parameters of lung function results(tidal volume,respiratory rate,ratio of time to peak tidal expiratory flow to total expiratory time,ratio of volume to peak tidal expiratory flow to total expiratory volume,peak expiratory flow,and breathing flow at 75%,50%,and 25% of tidal volume)of the two groups were compared,to compare the effects of two groups of noninvasive ventilation models on early lung function in the study subjects.Results(1)The endotracheal intubation rate of the BiPAP group was significantly lower than that of the CPAP group(P <0.05),but the average duration for noninvasive respiratory support,the average time of need to complementary oxygen,application of pulmonary surfactant,and the death rate was not significantly different in both groups(P >0.05).(2)Incidence of complications was not significantly different in both groups(P >0.05).(3)The BiPAP group had signifcantly lower respiratory rate,higher tidal volume(P <0.05),while ratio of time to peak tidal expiratory flow to total expiratory time,ratio of volume to peak tidal expiratory flow to total expiratory volume,peak expiratory flow,and breathing flow at 75%,50%,and 25% of tidal volume was not significantly different in both groups(P >0.05).Conclusions The data from this study show that BiPAP can reduce the incidence of endotracheal intubation and reduce the use of invasive ventilation compared with CPAP,which is safer and more effective in clinical efficacy,and as safe as CPAP.At the same time,compared with CPAP,BiPAP can improve lung compliance,promote the early recovery of lung function,improve the prognosis of children and improve the quality of life of children,which is worthy of clinical promotion.