Comparison Of The Effects And Safety Of Two Mechanical Ventilation Methods In The Treatment Of Extreme/Ultra-low Body Weight Neonatal Respiratory Distress Syndrome

Objective By comparing the differences between high frequency oscillatory ventilation(HFOV)and synchronous intermittent mandatory ventilation(SIMV)in the treatment of extreme/ultra-low body weight respiratory distress syndrome,objectively evaluate the efficacy of HFOV and its protective effect on the lungs,which is extremely low/ultra-low The clinical application of ventilator therapy for weight-bearing children provides a more detailed basis.Methods From January 2016 to January 2019,120 cases of severe neonatal respiratory distress syndrome(NRDS),weighing <1500g,and gestational age<34 weeks were selected in the Neonatal Intensive Care Unit(NICU)of our hospital.As subjects,they were divided into 2 groups according to different ventilator treatment modes,60 in the HFOV group and 60 in the SIMV group.Both groups received conventional treatments such as prenatal glucocorticoids and Pulmonary surfactant(PS),caffeine,etc.The partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),pH and oxygen index(OI)were compared between the two groups before and after treatment.The values of PaCO2,PaO2,PH and OI after treatment 1h,6h,12 h,24h and 48 h were compared between the two groups.The mechanical ventilation time,total oxygen consumption time and total hospitalization time were compared between the two groups.The mortality and complication rate were compared between the two groups.Data processing was performed using SPSS 21.0 software,and the test level was α=0.05.Results(1)Two groups in(sex,gestational age,birth weight,production style,1minApgar score)no statistical difference(P>0.05).(2)Two groups before treatment machine PaCO2,PaO2,PH,OI value no statistical difference(P>0.05).(3)Different periods of time after treatment compared with before treatment show,PH,PaO2 after treatment machine 1h,6h,12 h,24h,48 h were increased,statistically significant(P<0.05)difference,PaCO2,OI after treatment machine 1h,6h,12 h,24h,48 h were decreased,statistically significant.(4)The comparison between the two groups at various time points after treatment showed that the decrease of PaCO2 and OI in the HFOV group was higher than that in the SIMV group at 1h,6h and 12 h after the treatment,statistically significant(P< 0.05).There was no significant difference in PaCO2 and OI between 24 h and 48h(P>0.05).The increase of PaO2 in HFOV group was higher than that in SIMV group at 1h and 6h after operation,statistically significant(P<0.05).There was no significant difference in PaO2 between the two groups at 12 h,24h and 48 h after treatment(P>0.05).There was no significant difference in PH at 1h,6h,12 h,24h and 48 h after operation.(P>0.05).(6)The mechanical ventilation time,total oxygen consumption time and total hospitalization time in the HFOV group were lower than those in the SIMV group,astatistically significant(P< 0.05).(7)The mortality rate was 3.3% in the HFOV group and5% in the SIMV group.There was no significant difference between the two groups(P>0.05).(8)The incidence of ventilator-associated pneumonia(5%),pneumothorax(1.7%),and pulmonary hemorrhage(0%)in the HFOV group were lower than those in the SIMV group(16.3%)and pneumothorax(13.3).%),the incidence of pulmonary hemorrhage(10%),the difference was statistically significant(P< 0.05).The incidence of intracranial hemorrhage in the HFOV group(23.3%),the incidence of bronchopulmonary dysplasia(1.7%)and SIMV The incidence of intracranial hemorrhage(25%)and the incidence of bronchopulmonary dysplasia(3.3%)were not statistically significant(P>0.05).Conclusions(1)Both HFOV and SIMV are effective in the treatment of NRDS in very/ultra-low body weight infants.(2)HFOV improves oxygenation faster than SIMV.(3)HFOV is superior to SIMV in reducing the incidence of lung injury,and can reduce mechanical ventilation time,total oxygen consumption time and total hospitalization time.