Withdrawal of neonatal continuous positive airway pressure: Current practice in Australia
Withdrawal of neonatal continuous positive airway pressure: Current practice in Australia
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DOI：
10.1111/j.1442-200x.2008.02617.x
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发表时间：
2008-08-01
影响因子：
1.4
通讯作者：
Davies, Mark W.
中科院分区：
文献类型：
--
作者：
Jardine, Luke;Davies, Mark W.
背景：持续气道正压通气（CPAP）是一种被广泛接受的用于早产儿护理的呼吸支持方法。目前尚不清楚什么是CPAP开始后撤回的最佳策略。本调查的目的是确定澳大利亚呼吸科医生使用的鼻CPAP撤机的现行做法。第二个目的是建立什么标准的临床医生使用的失败关闭CPAP.Methods的指标：调查被发送到所有124个澳大利亚产科医生确定的中心列表中的澳大利亚和新西兰Neonatal network.Results：共发送了124份调查，86（69%）的答复，其中84（68%）的受访者完成了问卷。71%的受访者使用分级休息CPAP。大多数使用分级间歇CPAP的婴儿被认为是慢性（79%）或患有慢性新生儿肺病（73%）。共有74%的受访者的CPAP水平逐渐reduced.Conclusions：至少有48%的澳大利亚呼吸科医生使用分级的时间关闭CPAP。至少有50%的澳大利亚呼吸科医生在停止前放弃CPAP水平。新生儿科医生对重新开始CPAP有类似的标准，大多数人认为需氧量增加、呼吸功增加、呼吸暂停频率增加和呼吸暂停严重程度增加是重要指标。
Background: Continuous positive airway pressure (CPAP) is a widely accepted method of respiratory support used in the care of preterm infants. It remains unknown as to what is the best strategy for the withdrawal of CPAP once it has been commenced. The aim of the present survey was to establish the current practices for withdrawal of nasal CPAP used by Australian neonatologists. A secondary aim was to establish what criteria clinicians use as an indicator for failure off CPAP.Methods: Surveys were sent to all 124 Australian neonatologists identified by the list of centers in the Australia and New Zealand Neonatal Network.Results: A total of 124 surveys were sent; 86 (69%) replies were received, of which 84 (68%) of the respondents had completed the questionnaire. Seventy-one percent of respondents used a graded-time-off CPAP. The majority of babies for whom they used graded-time-off CPAP were deemed to be chronic (79%) or had chronic neonatal lung disease (73%). A total of 74% of respondents had the level of CPAP gradually reduced.Conclusions: At least 48% of Australian neonatologists use graded-time-off CPAP. At least 50% of Australian neonatologists wean the level of CPAP prior to cessation. Neonatologists have similar criteria for recommencing CPAP, with the majority considering increased oxygen requirement, increased work of breathing, increased frequency of apnea and increased severity of apnea important indicators.