Comparative efficacy of non-invasive ventilation methods in managing neonatal pneumonia: a clinical outcome study
Öz
Purpose: The aim of this study was was to compare the effectiveness and outcomes of non-invasive ventilation (NIV) methods in neonates diagnosed with lower respiratory tract infections (LRTI).
Materials and Methods: A prospective study was conducted in neonates with LRTI treated with high-flow nasal cannula (HFNC), nasal continuous positive airway pressure (NCPAP), or nasal intermittent positive pressure ventilation (NIPPV) in the neonatal intensive care unit. Method failure was defined as switching to another NIV method within 6 hours based on clinical and laboratory findings. The groups were compared for clinical and laboratory findings, length of hospital stay, outcomes, success rates, and complications.
Results: One hundred and six neonates were included with a median gestational age of 38 weeks and birth weight of 2991±673 g. Downes scores at admission were significantly higher in the NCPAP group than in the others. The HFNC group had better of blood pH and CO2 levels but had a higher rate of treatment failure. NCPAP was associated with the highest success rate (86.8%), followed by NIPPV (78.7%) and HFNC (52.4%). The length of hospital stay was shorter in patients successfully treated with NCPAP and NIPPV. According to the logistic regression analysis, NIPPV significantly reduced the risk of failure compared to HFNC.
Conclusion: NIPPV and NCPAP were more effective than HFNC in the management of neonatal LRTI with shorter hospital stay. HFNC may be effective in stabilizing baseline respiratory parameters in the management of neonatal LRTI.
Anahtar Kelimeler
Newborn, lower respiratory tract infection, non-invasive ventilation, high-flow nasal cannula, nasal CPAP, nasal IPPV.
Kaynakça
- Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD et al. RSV Global Epidemiology Network. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet.2017;390:946-58.
- Duke T. Neonatal pneumonia in developing countries. Arch Dis Child Fetal Neonatal Ed. 2005;90:211-9.
- Bresesti I, Lista G. Respiratory support of neonate affected by bronchiolitis in neonatal ıntensive care unit. Am J Perinatol. 2020;37:10-3.
- Ramaswamy VV, More K, Roehr CC, Bandiya P, Nangia S.Efficacy of noninvasive respiratory support modes for primary respiratory support in preterm neonates with respiratory distress syndrome: Systematic review and network meta-analysis.Pediatr Pulmonol. 2020;55:2940-63.
- Schlapbach LJ, Straney L, Gelbart B, Alexander J, Franklin D, Beca J et al. Burden of disease and change in practice in critically ill infants with bronchiolitis. Eur Respir J. 2017;49:1601648.
- Sinha IP, McBride AKS, Smith R, Fernandes RM. CPAP and high-flow nasal cannula oxygen in bronchiolitis. Chest. 2015;148:810-23.
- Slain KN, Shein SL, Rotta AT. The use of high-flow nasal cannula in the pediatric emergency department. J Pediatr. 2017;93:36-45.
- Coletti KD, Bagdure DN, Walker LK, Remy KE, Custer JW. High-flow nasal cannula utilization in pediatric critical care. Respir Care. 2017;62(8):1023-9.
- Subhi R, Adamson M, Campbell H, Weber M, Smith K, Duke T et al. Hypoxaemia in Developing Countries Study Group. The prevalence of hypoxaemia among ill children in developing countries. Lancet Infect Dis. 2009;9:219-27.
- Shi Y, Muniraman H, Biniwale M, Ramanathan R. A review on non-invasive respiratory support for management of respiratory distress in extremely preterm infants. Front Pediatr. 2020;8:270.
