Respiratory Insufficiency Clinical Trial
Official title:
Humidified High Flow Nasal Cannula Versus Nasal Intermittent Positive Ventilation in Neonates as Primary Respiratory Support:a Randomized Controlled Trial
The investigators hypothesize that the Humidified High Flow Nasal Cannula(HHFNC) is effective and safe as primary respiratory support in neonate with respiratory distress syndrome(RDS). It is more convenient in HHFNC combined with kangaroo care.
Today a new nursing principle proposed that is kangaroo care in neonate.Many study showed
kangaroo care may reduce pain、decrease the respiratory and heart rate among preterm
infant.The recently study show it benefit to Physical Growth and Neurodevelopment.
Respiratory failure remains a common problem in the neonatal intensive unit. As reported
that early non-invasive ventilation is accompanied by significant improvement in subsequent
lung development and alveolation.Nasal continuous positive airway pressure (NCPAP)、nasal
intermittent positive pressure ventilation(NIPPV) and humidified high flow via nasal
cannulas(HHFNC) are non-invasive ventilation models.But Unfortunately, NIPPV and NCPAP
systems are not always easily applied or tolerated in the preterm infants.So it is not
convenient in kangaroo care.Recently A meta analysis concluded that NIPPV is more effective
than NCPAP in preterms respiratory diseases.Maybe the investigators can reason that NIPPV is
effective than HHFNC,but there is limited data about the comparison of NIPPV and HHFNC as
primary respiratory support in neonate.
The NIPPV group fail definition:1、FiO2>40%、MAP>10 centimeter water column (cm H2O),but
SaO2<90%.2、significant abdominal distension.3、PaCO2>60 millimeter of mercury (mmHg)or
partial pressure of arterial oxygen (PaO2)<45mmHg.4、severe apnea( definition:>6 episodes
requiring stimulation in 6 hours or requiring >1 episodes of positive-pressure ventilation)
5.potential of hydrogen (PH)<7.2 The HHFNC group fail definition:1、FiO2>40%、flow>8
(litre,L)/min,but SaO2<90%.2、significant abdominal distension.3、PaCO2>60mmHg or
PaO2<45mmHg.4、severe apnea 5.PH<7.2
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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