Journal of Jilin University Medicine Edition ›› 2015, Vol. 41 ›› Issue (06): 1270-1274.doi: 10.13481/j.1671-587x.20150633

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Application of bilevel positive airway pressure in treatment of respiratory distress syndrome in preterm infants

ZHAO Xiaopeng1,2, SONG Yanyan2, ZHANG Lian2, CHEN Yanyan2, ZHOU Yuanli2, ZHANG Tingyan2   

  1. 1. Department of Neonatalogy, First Affiliated Hospital, Jinan University, Guangzhou 510630, China;
    2. Department of Neonatalogy, Guangzhou Women and Children's Medical Center, Guangzhou 510123, China
  • Received:2015-04-23 Published:2016-01-11

Abstract:

Objective To explore the influence of intubation-surfactant-extubation (InSurE) therapy combined with bilevel positive airway pressure (BiPAP) in the use time of mechanical ventilation,and to clarify the value of BiPAP in the treatment of respiratory distress syndrome in the preterm infants. Methods Toral 95 preterm infants with respiratory distress syndrome were treated with InSurE therapy during January 2011 to October 2014.Among them,the preterm infants before January 2013 were selected as control group who were treated with InSurE and nasal continuous positive airway pressure (nCPAP).After January 2013,60 preterm infants were treated with BiPAP,as BiPAP group.The rates of InSurE failure,the need for mechanical ventilation (MV) on the 7th day after InSurE failure,total non-invasive ventilation time,total mechanical ventilation time,atmospheric oxygen therapy time and incidence of clinical complications were compared between two groups. Results 1 There were no significant differences in the clinical data of the preterm infants between two groups,such as gender and age.2 Although there was no significant difference in the failure rate of InSurE,but the rate of repeated mechanical ventilation during 1 week in BiPAP group was lower than that in control group (P<0.01).3 The Rank sum test result showed that the total time of non invasive ventilation in BiPAP group was longer than that in control group (P<0.01).The total time of invasive mechanical ventilation and oxygen therapy in BiPAP group was lower than that in control group (P<0.05).4 The incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) in BiPAP group was lower than that in control group. Conclusion BiPAP can significantly reduce the use of invasive mechanical ventilation after the failure of InSurE,thereby decreases the oxygen toxicity and barotrauma hazards.

Key words: bilevel positive airway pressure, nasal continuous positive airway pressure, noninvasive ventilation support, respiratory distress syndrome, intubation-surfactant-extubation treatment, preterm infants

CLC Number: 

  • R722.6