Respiratory Insufficiency Clinical Trial
Official title:
Nasal High Frequency Oscillatory Versus Nasal Intermittent Positive Pressure Ventilation in Neonate After Extubation
To evaluate the efficacy and safety of nasal high frequency oscillatory ventilation(NHFOV) in preterms with respiratory disease syndrome(RDS) after extubation.
To very low birth weight infant(VLBW) with respiratory disease syndrome(RDS) who need
mechanical ventilation,early extubation may have more benefits.Early extubation may decrease
the ventilation-associated pneumonia(VAP),sepsis and decrease the incidence of severity
bronchopulmonary dysplasia(BPD).But often fail attempts at extubation because of
apnea,atelectasis,hypercapnia,hypoventilation or other illnesses.
High frequency oscillatory ventilation is benefit to lung.Initial ventilation with HFOV in
preterm with RDS may reduce the incidence of BPD and improve the neurodevelopment.Compared
HFOV with conventional ventilation in preterm infants showed that HFOV had superior lung
function when 11 to 14 years age.Whether nasal high frequency oscillatory ventilation(NHFOV)
also have those advantages in non-invasive mode? Null D M et al do a experiment on preterm
lambs,the result suggest that NHFOV may promotes alveolarization.But there was no clinical
trials to prove.
The nasal intermittent positive pressure ventilation (NIPPV) group fail definition:1、
Fraction of inspired oxygen (FiO2)>40%、MAP>12 centimeter water column (cm H2O),but arterial
oxygen saturation (SaO2)<90%.2、significant abdominal distension.3、PaCO2>60millimeter of
mercury(mmHg)or partial pressure of arterial oxygen (PaO2)<45 millimeter of
mercury(mmHg).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
The NHFOV group fail definition:1、FiO2>40%、MAP>14 mbar,but SaO2<90%.2、significant abdominal
distension.3、PaCO2>60millimeter of mercury(mmHg) or PaO2<45millimeter of
mercury(mmHg).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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