Bi-level Nasal Positive Airway Pressure(BiPAP)versus Nasal Continuous Positive Airway Pressure(CPAP)for Preterm Infants with Birth Weight Less Than 1500g and Respiratory Distress Syndrome Following INSURE Treatment:A Two-center Randomized Controlled Trial

The present study aimed to examine the effectiveness of bi-level positive airway pressure(BiPAP)versus continuous positive airway pressure(CPAP)in preterm infants with birth weight less than 1500 g and respiratory distress syndrome(RDS)following intubation-surfactant-extubation(INSURE)treatment.A two-center randomized control trial was performed.The primary outcome was the reintubation rate of infants within 72 h of age after INSURE.Secondary outcomes included bronchopulmonary dysplasia(BPD),necrotizing enterocolitis(NEC),retinopathy of prematurity(ROP)and incidences of adverse events.Lung function at one year of corrected age was also compared between the two groups.There were 140 cases in the CPAP group and 144 in the BiPAP group.After INSURE,the reintubation rates of infants within 72 h of age were 15%and 11.1%in the CPAP group and the BiPAP group,respectively(P>0.05).Neonates in the BiPAP group was on positive airway pressure(PAP)therapy three days less than in the CPAP group(12.6 d and 15.3 d,respectively,P<0.05),and on oxygen six days less than in the CPAP group(20.6 d and 26.9 d,respectively,P<0.05).Other outcomes such as BPD,NEC,ROP and feeding intolerance were not significantly different between the two groups(P>0.05).There was no difference in lung function at one year of age between the two groups(P>0.05).In conclusion,after INSURE,the reintubation rate of infants within 72 h of age was comparable between the BiPAP group and the CPAP group.BiPAP was superior to CPAP in terms of shorter durations(days)on PAP support and oxygen supplementation.There were no differences in the incidences of BPD and ROP,and lung function at one year of age between the two ventilation methods.

Sildenafil versus continuous positive airway pressure for erectile dysfunction in men with obstructive sleep apnea： a comparat-ive study of their efficacy and safety and the patient＇s satisfaction with treatment

Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.

Relationship between intubation rate and continuous positive airway pressure therapy in the prehospital setting

BACKGROUND: To determine whether the prehospital use of continuous positive airway pressure(CPAP) therapy is associated with a reduced rate of endotracheal intubation in patients with an acute respiratory disorder brought to the emergency department(ED).METHODS: We reviewed medical records of patients with acute respiratory distress who had been treated with CPAP in the Mobile Intensive Care Unit(MICU) from January 2010 to December 2011. These records were compared with those of patients who received standardized care without CPAP in the MICU from January 2004 to December 2004. Categorical variables were summarized as frequencies and compared between groups using Fisher's exact test or the Chi-square test. Continuous variables were summarized as medians(interquartile range), and comparison between the groups was made using Wilcoxon's rank-sum test. The relationship between CPAP and intubation rate was determined using multivariable logistic regression analysis of propensity scores. The results were presented as odds ratio(OR), 95% confidence interval(CI), and P value for test effect. The adequacy of the model was calibrated using Hosmer and Lemeshow's goodness-of-fit test. P<0.05 was considered statistically significant.RESULTS: The records of 785 patients were reviewed. Of the 215 patients treated with CPAP in the MICU, 13% were intubated after admission. In contrast, of the 570 patients who did not receive CPAP, 28% were intubated after ED admission. Unadjusted logistic regression analysis showed that patients who had been treated with CPAP were less likely to be intubated than those without CPAP treatment(OR=0.37, 95% CI, 0.24–0.57, P<0.0001). With propensity scores adjusted, multivariate logistic regression analysis showed that CPAP treatment was associated with a 62% reduction of intubation(OR=0.384, 95%CI, 0.25–0.60, P≤0.0001).CONCLUSIONS: In patients with acute respiratory disorder, there was a relationship between CPAP therapy and the decreased intubation rate. CPAP therapy was feasible in prehospital management of patients with respiratory distress.

Impact of continuous positive airway pressure therapy for nonalcoholic fatty liver disease in patients with obstructive sleep apnea

BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for CPAP.Liver fibrosis and steatosis were assessed using TE.Before and after 6 mo of CPAP therapy,serum markers and TE were assessed for all patients.The mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP therapy.Univariate analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT level.In multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT levels.Meanwhile,no significant changes in TE data or serum fibrosis markers were seen.CONCLUSION Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW changes.In those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.

Continuous positive airway pressure for treating hypoxemia due to pulmonary vein injury:A case report

BACKGROUND Vascular injury during thoracoscopic surgery for esophageal cancer is a rare but life-threatening complication that can lead to severe hypotension and hypoxemia.Anesthesiologists need to provide rapid and effective treatment to save patients'lives.CASE SUMMARY A 54-year-old male patient was scheduled to undergo a thoracoscopic-assisted radical resection of esophageal cancer through the upper abdomen and right chest.While dissociating the esophagus from the carina through the right chest,unexpected profuse bleeding occurred from a suspected pulmonary vascular hemorrhage.While the surgeon attempted to achieve hemostasis,the patient developed severe hypoxemia.The anesthesiologist implemented continuous positive airway pressure(CPAP)using a bronchial blocker(BB),which effectively improved the patient’s oxygenation and the operation was completed success-fully.CONCLUSION CPAP using a BB can resolve severe hypoxemia caused by accidental injury of the left inferior pulmonary vein during surgery.

Clinical efficacy of mask continuous positive airway pressure mechanical ventilation in children with severe pneumonia

Objective: To investigate the clinical effects of the mask continuous positive airway pressure (CPAP) mechanical ventilation in children with severe pneumonia. Methods: A total of 100 cases of children with severe pneumonia were randomly divided into two groups, study group with 50 children and control group with 50 children. These 100 children were given comprehensive treatment measures: treatment of anti-infection, anti-respiratory failure, anti-heart failure (if necessary), relieving cough and reducing sputum, aerosol inhalation, limited fluid volume, nutrition support etc. Children in the study group were added mask continuous positive airway pressure mechanical ventilation (CPAP). Children in the control group were added ordinary mask oxygen inhalation. Investigated and checked the treatment effect in these two groups. Results: After treatment, SaO2, PaO2 in both two groups were showed significantly higher than before the treatment. PaO2 of the study group is obviously higher than the control group. The oxygen inhalation time of the study group was obviously lesser than the control group. The total effective rate of the study group was significantly higher than the control group which was 96.0% vs 66.0%. Conclusion: The mask continuous positive airway pressure (CPAP) mechanical ventilation can significantly improve the related symptoms and blood gas status of the children with severe pneumonia, shorten the oxygen inhalation time and had remarkable effect.

Changes in Brachial and Central Blood Pressure after Short Term Continuous Positive Airway Pressure Treatment of Patients with Moderate-to-Severe Obstructive Sleep Apnoea and Impaired Renal Function

Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.

Continuous positive airway pressure to improve insulin resistance and glucose homeostasis in sleep apnea

Obstructive sleep apnea syndrome(OSAS)is a relatively common disorder in the adult population.It is associated with alterations in glucose metabolism and increases the risk for diabetes mellitus.Continuous positive airway pressure(CPAP)is the treatment of choice for OSAS.It may also have a favorable effect on insulin resistance and glucose metabolism,although relevant data is conflicting.Additional research is still needed to fully establish the effect of CPAP on glucose homeostasis.It should ascertain which patients may benefit most and how long treatment takes to induce favorable changes.Finally,patient compliance is being appreciated as a major factor influencing therapeutic outcomes,and this needs to be further examined.

Continuous Positive Airway Pressure Effectively Alleviates Arrhythmias in Patients with Obstructive Sleep Apnea:Possible Relationship with Counteracting Oxidative Stress

This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.

Effect of continuous positive airway pressure therapy on glucose control

Obstructive sleep apnea (OSA) and diabetes mellitus are both highly prevalent disorders.There has been a recent recognition of an association between insulin resistance and sleep apnea.Continuous positive airway pressure (CPAP) has emerged as an effective therapy for treatment of OSA and has been shown to positively influence numerous pathophysiological factors that con-tribute to cardiovascular risk.There is emerging data that explores the influence of CPAP therapy,insulin sensitivity and glycemic control.In the current review,we examine this literature critically and formulate a synopsis that summarizes the current knowledge in this field.

Effect of continuous positive airway pressure ventilation on nocturnal ST-segment changes in patients with sleep-disordered breathing

Objective To determine whether sleep-disordered breathing (SDB) may lead to nocturnal myocardial ischemia and whether the severity of this ischemia may be relieved by nasal continuous positive airway pressure (CPAP). Methods Overnight polysomnogram examination and simultaneous 3-channel Holter monitoring were performed on 76 patients with moderate to severe SDB and no history of coronary heart disease. All the cases were treated with CPAP for one night. ST depression was defined as a ST segment decrease of more than 1 mm from baseline and lasting 1 min or more. The total duration (minutes) of ST depression was indexed to the total sleep time (minutes per hour of sleep). Results Twenty-eight patients (37%) showed ST segment depression during their sleep. Before CPAP treatment, the respiratory disturbance index (RDI) and arousal index were significantly higher during periods of ST depression than when ST segments were isoelectric, whereas no significant difference was found in blood oxygen saturation (SaO2). After the CPAP treatment of patients with ST depression, the duration of ST depression was significantly reduced from 36.8±18.9 to 11.4±13.2 min/h (P<0.05). ST depression-related indexes, including RDI, arousal index and the percentage of sleep time spent at SaO2 below 90% (TS90/ TST), were all significantly decreased, with RDI from 63.4±23.8 to 8.1±6.6 /h, arousal index from 51.2±18.9 to 9.6±5.4 /h, and TS90/ TST from 50.6±21.4 to 12.9±14.7% (P<0.05). Conclusion ST-segment depression is rather common in patients with moderate to severe SDB, and CPAP treatment can significantly reduce the duration of ST depression. ST depression in these patients may reflect the myocardial ischemia that really exists and the non-ischemic changes associated with recurrent SDB.

Safety of restarting continuous positive airway pressure (CPAP) therapy following endoscopic endonasal skull base surgery

Objectives:Patients with obstructive sleep apnea(OSA)are at increased risk of perioperative and postoperative morbidity.The use of continuous positive airway pressure(CPAP)in the perioperative period may be of potential benefit.However,among patients who have undergone endonasal skull base surgery,many surgeons avoid prompt re-initiation of CPAP therapy due to the theoretical increased risk of epistaxis,excessive dryness,pneumocephalus,repair migration,intracranial introduction of bacteria,and cerebrospinal fluid(CSF)leak.The objective of this article is to review the most up-to-date literature regarding when it is safe to resume CPAP usage in the patient undergoing endonasal skull base surgery.Data Sources and Methods:This review combines the most recent literature as queried through PubMed regarding the safety of CPAP resumption following endonasal skull base surgery.Results:Recent surveys of skull base surgeons demonstrate little consensus regarding the post-operative management of OSA.Recent cadaveric studies suggest that approximately 85%of delivered CPAP pressures are transmitted to the sphenoid sinus.Further,at frequently prescribed CPAP pressure settings,common sellar reconstruction techniques maintain their integrity while preventing very little transmission of pressure into the sella.In small retrospective case series,patients with OSA who received CPAP immediately following transsphenoidal pituitary surgery had similar rates of surgical complications as OSA patients who did not receive CPAP in the immediate post-operative period.Concerns of reinitiating CPAP too early,such as the development of pneumocephalus,rarely develop.Conclusions:There remains a paucity of objective data regarding when it is safe to resume CPAP following endonasal skull base surgery.Recent cadaveric studies and small retrospective case series suggest that it may be safe to resume CPAP earlier than is often practiced following endonasal skull base surgery.

NCPAP序贯高流量鼻导管湿化氧疗治疗新生儿肺炎合并呼吸衰竭效果

目的:探究经鼻持续气道正压通气(NCPAP)序贯高流量鼻导管湿化氧疗(HHFNC)治疗新生儿肺炎合并呼吸衰竭(RF)效果。方法:选取2019年1月-2023年3月本院接受治疗的肺炎合并RF新生儿102例,随机分为常规组(NCPAP序贯常规鼻导管吸氧治疗)和观察组(NCPAP序贯HHFNC治疗)各51例,比较两组治疗后临床症状消失时间,治疗24 h后血气指标、炎症因子水平、免疫功能。结果:治疗后临床症状消失时间观察组短于常规组;治疗24 h后,两组血氧分压、氧合指数及pH水平均升高且观察组(76.36±7.28 mmHg、204.75±20.15mmHg、7.25±0.59)均高于常规组(72.57±7.05mmHg、193.07±19.47mmHg、6.93±0.51),呼吸频率(51.43±3.67次/min)低于常规组(53.82±4.16次/min),两组炎症因子及免疫球蛋白水平均降低,且观察组C反应蛋白(9.25±1.06 mg/L)、中性粒细胞与淋巴细胞比值(1.22±0.31)、降钙素原(1.17±0.31 ng/L)均低于常规组(10.84±1.27 mg/L、1.48±0.36、1.41±0.45 ng/L)(均P<0.05)。结论:NCPAP序贯HHFNC可缩短肺炎合并RF新生儿临床症状改善时间,调节患儿血气指标及免疫功能,减轻炎症反应。

微信小程序改善阻塞性睡眠呼吸暂停低通气综合征患者CPAP治疗依从性及疗效的应用研究

目的:评价基于微信小程序的移动管理平台是否改善阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者持续正压通气治疗(continuous positive airway pressure,CPAP)的疗效及依从性。方法:选择2022年6月至2022年12月在重庆市人民医院确诊为中重度OSAHS并进行CPAP治疗的68例患者为研究对象。入组患者分为微信小程序管理组(n=36)和传统门诊随访组(n=32)。在第3个月和第6个月评估患者CPAP治疗疗效及依从性、CPAP治疗的不良反应和主观睡眠质量。结果:与门诊随访组比较,微信小程序组在治疗后3个月的睡眠呼吸暂停指数(apnea-hypopnea index,AHI)及Epworth嗜睡程度评价(Epworth sleepiness scale score,ESS)评分更低(P<0.05),但在治疗后6个月的AHI和ESS与门诊随访组比较差异无统计学意义(P>0.05)。与门诊随访组比较,微信小程序组在治疗后3个月和6个月每晚使用CPAP时间及每月使用的天数更多(P<0.05)。结论:基于微信小程序的OSAHS移动管理平台能够有效提高OSAHS患者CPAP的依从性及改善短期疗效。

双黄连氧气驱动雾化吸入联合NCPAP治疗对MP合并呼吸衰竭患儿的影响

目的探讨采取双黄连氧气驱动雾化吸入联合经鼻持续气道正压通气(NCPAP)治疗儿童重症支原体肺炎(MP)合并呼吸衰竭的效果及对血清瘦蛋白(Leptin)、白细胞介素⁃17(IL⁃17)及白细胞介素⁃33(IL⁃33)水平的影响。方法选取82例患儿并随机分成观察组42例与对照组40例,对照组采取常规吸氧、止咳及NCPAP治疗,观察组则是在对照组的基础上加用双黄连氧气驱动雾化吸入治疗,比较2组治疗效果。结果观察组患儿各症状消退时间明显比对照组短(P<0.05);治疗后2组血氧饱和度(SaO_(2))、血氧分压(PaO_(2))较治疗前提高,二氧化碳分压(PaCO_(2))较治疗前降低,而观察组指标变化幅度较对照组显著(P<0.05);治疗后2组血清Leptin、IL⁃17、IL⁃33均较治疗前降低,观察组各指标显著低于对照组(P<0.05)。结论双黄连氧气驱动雾化吸入联合NCPAP治疗儿童重症MP合并呼吸衰竭,可显著改善患儿血气功能指标,降低血清炎症因子水平,促进患儿症状的改善。

CPAP联合珂立苏治疗新生儿呼吸窘迫综合征（RDS）的临床研究

目的研究珂立苏联合持续正压通气（CPAP）治疗新生儿呼吸窘迫综合征（RDS）的临床效果。方法：选取新生儿呼吸窘迫综合征（RDS）患儿60例，随机分为观察组31例和对照组29例。观察组给予王可立苏联合CPAP治疗，对照组给予CPAP治疗。结果：从2d内各时间点的x线胸片结果看见：两组在接受治疗之后检查评分逐渐降低，且观察组低于对照组（P〈0．05）；患儿3d内存活率：观察组93．5％，高于对照组的51．72%（P〈0．05）。结论：珂立苏联合CPAP治疗新生儿呼吸窘追综合征（RDS）疗效显著，可改善新生儿的肺通气功能，大大降低新生儿呼吸窘迫综合症（RDS）的死亡率。

早产儿呼吸暂停采取NCPAP联合枸橼酸咖啡因治疗的临床效果分析

目的 分析早产儿呼吸暂停通过持续气道正压通气(NCPAP)联合枸橼酸咖啡因进行治疗的临床效果。方法 110例呼吸暂停早产儿,根据治疗方式不同分为单纯NCPAP治疗组(37例)、单纯咖啡因治疗组(37例)、联合治疗组(36例)。单纯NCPAP治疗组使用单纯NCPAP治疗,单纯咖啡因治疗组使用单纯枸橼酸咖啡因治疗,联合治疗组采用NCPAP联合枸橼酸咖啡因治疗。对比三组患儿疗效、并发症发生率、临床指标、血气指标、肺功能指标、发育情况。结果 联合治疗组患儿总有效率为97.22%,高于单纯NCPAP治疗组的67.57%、单纯咖啡因治疗组的64.86%,差异具有统计学意义(P<0.05)。联合治疗组患儿并发症发生率为5.56%,低于单纯NCPAP治疗组的32.43%、单纯咖啡因治疗组的35.14%,差异具有统计学意义(P<0.05)。联合治疗组患儿住院时间(18.20±3.86)d、呼吸暂停时间(15.12±2.31)s/次短于单纯NCPAP治疗组的(24.69±5.67)d、(19.46±3.67)s/次和单纯咖啡因治疗组的(24.78±5.58)d、(19.56±3.78)s/次,呼吸暂停次数(1.15±0.14)次/d少于单纯NCPAP治疗组的(2.32±0.46)次/d和单纯咖啡因治疗组的(2.33±0.57)次/d,差异具有统计学意义(P<0.05)。治疗后,联合治疗组患儿动脉血二氧化碳分压(40.27±3.30)mm Hg(1 mm Hg=0.133 kPa)低于单纯NCPAP治疗组的(45.27±4.78)mm Hg、单纯咖啡因治疗组的(45.38±4.89)mm Hg,动脉血氧分压(78.32±6.87)mm Hg、pH值(7.42±0.05)高于单纯NCPAP治疗组的(69.85±5.46)mm Hg、(7.38±0.03)和单纯咖啡因治疗组的(69.85±5.47)mm Hg、(7.39±0.04),差异具有统计学意义(P<0.05)。治疗后,联合治疗组患儿运动评分(111.36±19.88)分、智力评分(113.68±18.53)分高于单纯NCPAP治疗组的(96.71±20.86)、(98.62±17.58)分和单纯咖啡因治疗组的(96.82±20.98)、(98.71±17.47)分,差异具有统计学意义(P<0.05)。联合治疗组患儿潮气量(8.58±1.68)ml/kg、达峰容积比(37.59±1.68)%、达峰时间比(36.38±1.55)%、每分通气量(0.78±0.29)L/(min·kg)、25%潮气量时呼气流速(36.88±1.36)ml/s、75%潮气量时呼气流速(36.78±1.49)ml/s均高于单纯NCPAP治疗组的(7.64±1.08)ml/kg、(33.06±1.51)%、(33.56±1.37)%、(0.47±0.16)L/(min·kg)、(32.11±1.62)ml/s、(34.13±1.25)ml/s和单纯咖啡因治疗组的(7.53±1.14)ml/kg、(33.04±1.42)%、(33.57±1.48)%、(0.49±0.27)L/(min·kg)、(32.22±1.73)ml/s、(34.26±1.36)ml/s,差异具有统计学意义(P<0.05)。结论 为呼吸暂停早产儿实施NCPAP联合枸橼酸咖啡因治疗,可以改善患儿临床指标,促进患儿神经发育,减少并发症,提升治疗效果,临床应用价值较高。

肺表面活性物质联合NCPAP辅助通气对NRDS患儿症状改善时间的影响分析

目的分析肺表面活性物质(Pulmonary Surfactant,PS)联合经鼻持续气道正压通气(Nasal Continuous Positive Airway Pressure Ventilation,NCPAP)辅助通气对新生儿呼吸窘迫综合征(Neonatal Respiratory Distress Syndrome,NRDS)患儿症状改善时间的影响。方法回顾性选取2019年1月—2023年6月京山市人民医院收治的68例NRDS患儿的临床资料,依据治疗方式的不同分为观察组与对照组,每组34例。对照组的治疗方式为NCPAP,观察组的治疗方式为NCPAP联合PS药物。对比两组患儿动脉血气分析指标以及治疗情况。结果治疗1 d后,与对照组比较,观察组的各项动脉血气分析指标均出现更明显的改善,差异有统计学意义(P均<0.05)。观察组的症状改善时间为(1.04±0.57)d,明显比对照组短,差异有统计学意义(t=12.393,P<0.05);同时观察组的氧疗时间、通气时间、住院时间住院均优于对照组,差异有统计学意义(P均<0.05)。结论NRDS患儿采用NCPAP联合PS药物治疗有利于改善血气指标,缩短其临床症状改善时间。

鼻塞式持续气道正压通气（NCPAP）与无创双水平正压通气（BiPAP）在小儿肺炎合并呼吸衰竭中的疗效比较

目的分析鼻塞式持续气道正压通气（NCPAP）与无创双水平正压通气（BiPAP）在小儿肺炎合并呼吸衰竭中的疗效比较：方法：随机将80例小儿肺炎并呼吸衰竭患儿分成对照组和实验组，每组各40例；结果：在临床治疗有效率方面．两组患儿比较差异无统计学意义（P〉O．05）。结论：临床中在治疗肺炎合并呼吸衰竭患儿时，鼻塞式持续气道正压通气（NCPAP）的治疗效果和BiPAP的治疗效果相近。

氨溴索PS及联合nCPAP预防早产儿呼吸窘迫综合征的疗效比较

目的比较氨溴索、肺表面活性物质(PS)及联合nCPAP预防早产儿呼吸窘迫综合征(NRDS)的疗效。方法回顾性分析109例早产儿使用氨溴索、肺表面活性物质及联合nCPAP预防NRDS的血气指标、吸氧时间、并发症、对机械通气需求、住院时间及病死率。结果 3种治疗方法均可以迅速改善患儿的血气指标,与PS组和氨溴索+nCPAP组相比,PS+nCPAP组PaO2升高(F=38.050,P=0.000)、PaCO2下降(F=23.618,P=0.000)和血pH值(F=44.072,P=0.000)恢复更为理想;PS+nCPAP组吸氧时间最短(F=7.422,P=0.001),且住院时间最短(F=3.409,P=0.037)。结论 PS联合nCPAP预防早产儿NRDS效果最佳,但氨溴索联合nCPAP更为经济,适用于某些无条件使用PS的患儿。