Effect Difference of Sequential nCPAP and High-flow Nasal Catheter Humidification Oxygen Therapy after Mechanical Ventilation Withdrawal in Neonatal Pneumonia with Respiratory Failure
HE Yanzhi, LI Yanjuan
Shiyan Maternal and Child Health Hospital, Hubei Shiyan 442000, China
Abstract：Objective: To investigate the efficacy of sequential nasal continuous positive airway pressure (NCPAP) and humidified high-flow nasal cannula (HHFNC) after weaning from mechanical ventilation on neonatal pneumonia with respiratory failure. Methods: A total of 110 children patients with neonatal pneumonia complicated with respiratory failure admitted to our hospital were divided into control group (55 cases) and observation group (55 cases) by simple randomization grouping according to the random number table method. Control group was given NCPAP treatment after weaning from mechanical ventilation, and observation group was given HHFNC treatment after weaning from mechanical ventilation. The clinical efficacy, blood gas analysis indicators and respiratory rate, oxygenation index, inflammatory factors, immune function indicators and complications were analyzed in the two groups. Results: There was no significant difference in the total effective rate of treatment between the two groups (P>0.05). Before treatment, there were no statistically significant differences in the partial pressure of arterial oxygen (PaO2), partial pressure of arterial blood carbon dioxide (PaCO2), blood oxygen saturation (SaO2), oxygenation index (P/F) and respiratory rate between the two groups (P>0.05). After 24h of treatment, the differences of SaO2 and P/F before and after treatment in observation group were significantly higher than those in control group (P<0.05), and there were no significant differences in the differences of other indicators compared with those in control group (P>0.05). Before treatment, there were no statistically significant differences in the levels of inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT)] and immune function indexes [immunoglobulins (IgA, IgM, IgG)] between the two groups (P>0.05). After 24h of treatment, the differences of inflammatory factors and immune function indexes before and after treatment in observation group were significantly greater than those in control group (P<0.05). During treatment, the incidence rate of complications in observation group was significantly lower than that in control group (P<0.05). Conclusion: Sequential HHFNC after weaning from mechanical ventilation has similar efficacy with NCPAP in the treatment of neonatal pneumonia with respiratory failure, but sequential HHFNC can effective improve the inflammatory response, enhance the immune function of children patients, and reduce the risk of complications.
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2020, Vol. 26 
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