The Effect of Extended Continuous Positive Airway Pressure on Changes in Lung Volumes in Stable Premature Infants: A Randomized Controlled Trial.
The Effect of Extended Continuous Positive Airway Pressure on Changes in Lung Volumes in Stable Premature Infants: A Randomized Controlled Trial.
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DOI：
10.1016/j.jpeds.2019.07.074
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发表时间：
2020-02
期刊：
影响因子：
--
通讯作者：
McEvoy CT
中科院分区：
文献类型：
--
作者：
Lam R;Schilling D;Scottoline B;Platteau A;Niederhausen M;Lund KC;Schelonka RL;MacDonald KD;McEvoy CT
比较随机接受持续气道正压通气（eCPAP）与CPAP停药（dCPAP）2周的稳定期婴儿出院时肺容量的变化（通过功能残气量（FRC）测量）。当满足CPAP稳定性标准时，将需要≥24小时CPAP的妊娠≤32周出生的婴儿随机分配至2周eCPAP组和dCPAP组。FRC用氮气冲洗技术测量。婴儿按胎龄（<28和≥ 28周）和双胎妊娠分层。使用线性混合效应模型评价2组间FRC的变化。数据分析对治疗组分配设盲。50名婴儿随机分组，排除6名，共44名婴儿。两组的基线特征相似。随机分配至eCPAP组的婴儿与随机分配至dCPAP组的婴儿相比，从随机化至2周（12.6 mL vs 6.4 mL;调整后的95% CI，0.78-13.47; P = 0.03）和从随机化至出院（27.2 mL vs 17.1 mL;调整后的95% CI，2.61-17.59; P = 0.01）的FRC增幅更大。与随机分配至dCPAP组的早产儿相比，随机分配至eCPAP组的早产儿出院时FRC的增加显著更大。FRC的变化增加可能会改善呼吸系统健康。ClinicalTrials.gov：NCT02249143。
To compare changes in lung volumes, as measured by functional residual capacity (FRC), through to discharge in stable infants randomized to 2 weeks of extended continuous positive airway pressure CPAP (eCPAP) vs CPAP discontinuation (dCPAP). Infants born at ≤32 weeks of gestation requiring ≥24 hours of CPAP were randomized to 2 weeks of eCPAP vs dCPAP when meeting CPAP stability criteria. FRC was measured with the nitrogen washout technique. Infants were stratified by gestational age (<28 and ≥ 28 weeks) and twin gestation. A linear mixed-effects model was used to evaluate the change in FRC between the 2 groups. Data were analyzed blinded to treatment group allocation. Fifty infants were randomized with 6 excluded, for a total of 44 infants. Baseline characteristics were similar in the 2 groups. The infants randomized to eCPAP vs dCPAP had a greater increase in FRC from randomization through 2 weeks (12.6 mL vs 6.4 mL; adjusted 95% CI, 0.78–13.47; P = .03) and from randomization through discharge (27.2 mL vs 17.1 mL; adjusted 95% CI, 2.61–17.59; P = .01). Premature infants randomized to eCPAP had a significantly greater increase in FRC through discharge compared with those randomized to dCPAP. An increased change in FRC may lead to improved respiratory health. ClinicalTrials.gov: NCT02249143.
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