Study on LISA Combined with Different Non-invasive Ventilation Modes in the Treatment of Respiratory Distress Syndrome in Premature Infants
Objective To explore the clinical efficacy and safety of less invasive surfactant administration(LISA)combined with different non-invasive ventilation modes in the treatment of respiratory distress syndrome(RDS)in premature infants.Methods From January 2022 to May 2023,118 preterm infants(gestation age≤34 weeks)with RDS born and treated in the Neonatology Department of the Second People's Hospital of Shenzhen and the People's Hospital of Hechi were randomly assigned into nasal intermittent positive pressure ventilation(NIPPV)group and nasal continuous positive airway pressure(NCPAP)group.Among them,there were 56 cases in the NIPPV group and 62 cases in the NCPAP group.Both groups were treated with LISA technique.NIPPV and NCPAP were treated before,during and after administration,respectively.the blood gas analysis before and 1 and 6 h after administration,clinical efficacy,complications and adverse reactions were compared between the two groups.Results The potential of hydrogen(pH)and arterial partial pressure of oxygen(PaO2)of NIPPV group at 1 h and 6 h after PS injection were significantly higher than those of NCPAP group at corresponding time points,while the arterial partial pressure of carbon dioxide(PaCO2)was lower than that of NCPAP group,with statistical significances(P＜0.05).Compared with NCPAP group,the mechanical ventilation rate of tracheal intubation with in 72 h,the incidence of apnea,the rate of multiple use of PS,non-invasive respiratory support time and total oxygen use time were decreased in NIPPV group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the duration of invasive ventilation between the two groups of patients(P＞0.05).The incidence of bronchopulmonary dysplasia(BPD)in NIPPV group was lower than that of NCPAP group,and the difference was statistically significant(P＜0.05).There was no significant difference in the incidence of retinopathy of prematurity(ROP),intra-ventricular hemorrhage(IVH),neonatal necrotizing enterocolitis(NEC),feeding intolerance(FI),air leakage syndrome,PS drug reflux and nasal injury between the two groups(P＞0.05).Conclusion In the treatment of premature infants with RDS by LISA technology combined with different ventilation modes,NIPPV can effectively improve oxygenation,reduce carbon dioxide retention,reduce mechanical ventilation rate within 72 h,shorten the time of non-invasive respiratory support,and reduce the occurrence of BPD,which can be used as the initial mode in the clinical application of premature infants with RDS.
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