Yenidoğanlarda Ekstübasyon Sonrası Non-İnvaziv Solunum Desteğinde Kullanılan İki Farklı Nazal Arayüzün Ekstübasyon Başarısına Etkisi

Yıl 2024, Cilt: 21 Sayı: 2, 266 - 270, 29.08.2024

Mehmet Fatih Deveci , İsmail Kürşad Gökçe

https://doi.org/10.35440/hutfd.1452759

Öz

Amaç: Yenidoğanlarda ekstübasyon sonrası non-invaziv ventilasyon desteği sıklıkla kullanılmaktadır. Non-invaziv ventilasyon desteğinin etkinliği, kullanılan nazal arayüzün tipiyle ilişkilidir. Çalışmamızda nazal arayüz tipinin ekstübasyon başarısına etkisini araştırmayı amaçladık.
Materyal ve Metod: Non-invaziv ventilasyona ekstübe edilen toplam 105 term ve preterm hastayı retrospektif olarak değerlendirdik. Hastaları, kullanılan nazal arayüz tipine gore; RAM kanül veya kısa binazal prong (KBP) olarak iki gruba ayırdık. İki grup arasındaki ekstübasyon başarısızlığını inceledik.
Bulgular: Hastaların 63'ü RAM kanül grubunda, 42'si KBP grubunda olup hastaların demografik özellikleri benzerdi. Gruplar arasında ekstübasyon başarısızlık oranları açısından istatistiksel olarak anlamlı fark yoktu (RAM; %44.4 vs KBP; %38.1, p=0.518). RAM kanül grubu KBP grubuna gore; daha yüksek başlangıç ortanca pozitif ekspirasyon sonu basınç (positive end expiratory pressure=PEEP) değerine (7.0 ve 6.5 cmH2O, p=0.038; sırasıyla) ve daha düşük ortanca solunum hızına (60 ve 62/dakika, p=0.032; sırasıyla) sahipti.
Sonuç: Kullanımı daha kolay RAM kanülünün seçilmiş hastalarda özellikle PEEP değerinin yaklaşık olarak 1 cmH2O daha yüksek ayarlanmasıyla kullanılabileceğini düşünüyoruz.

Anahtar Kelimeler

RAM kanül, kısa binazal prong, nazal arayüz, ekstübasyon başarısı, non-invaziv ventilasyon

The Effect of Two Different Nasal Interfaces Used in Post-Extubation Non-Invasive Respiratory Support on Extubation Success in Newborns

Öz

Background: Non-invasive ventilation support is frequently used in newborns after extubation. The efficiency of non-invasive ventilation support is associated to type of nasal interface used. We aimed to investigate the effect of nasal interface type in our study on extubation success.
Materials and Methods: We retrospectively evaluated a total of 105 term and preterm patients who were extubated to non-invasive ventilation. We divided the patients into two groups according to nasal interface type: RAM cannula or short binasal prongs (SBPs). We examined extubation failure between the two groups.
Results: While 63 of the patients were in RAM cannula group, 42 of them were in SBPs group, and the demographic characteristics of the patients were similar. There was no statistically significant differen-ce in the extubation failure rates between the groups (RAM; %44.4 vs SBPs; %38.1, p=0.518). The Ram cannula group had a higher beginning median positive end-expiratory pressure value (7.0 vs 6.5 cmH2O, p=0.038; respectively) and a lower median respiratory rate (60 vs 62/minute, p=0.032; res-pectively) than the SBPs group.
Conclusions: We believe that the easy-to-use RAM cannula can be used in selected patients, especially by setting the PEEP value approximately 1 cmH2O higher.

Anahtar Kelimeler

RAM cannula, short binazal prongs, nasal interface, extubation success, non-invasive ventilation

Kaynakça

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