Effects of Different Mechanical Ventilation Modes Combined with Pulmonary Surfactant on the Treatment of Preterm Infants with Neonatal Respiratory Distress Syndrome

Abstract

Objective To study the clinical effects of nasal continuous positive airway pressure (NCPAP), controlled mandatory ventilation (CMV) or synchronized intermittent mandatory ventilation (SIMV) combined with pulmonary surfactant (PS) on the treatment of neonatal respiratory distress syndrome (NRDS). Methods From January 2010 to March 2013, a total of 118 cases preterm infants with NRDS who hospitalized in Suining Central Hospital were selected into this study. They were divided into study group (n = 61, accepted NCPAP combined with PS treatment) and control group (n = 57, accepted CMV or SIMV combined with PS treatment). The study protocol was approved by the Ethical Review Board of Investigation in Suining Central Hospital. Informed consent was obtained from the guardians of each participate. Within 2 h after hospitalization, NCPAP combined with PS (study group), CMV or SIMV combined with PS (control group) were given to preterm infants with NRDS in two groups, respectively. Then results of blood gas analysis,duration of mechanical ventilation,duration of oxygen inhaled, hospitalization stay, incidence rate of complications and mortality were analyzed by statistic methods. Results ① There were no statistically significant differences between two groups in gender, gestational age, age, birth weight and NRDS classification (P>0.05). ② There were no statistically significant differences between two groups in results of blood gas analysis at different time points and mortality (P>0.05).③ Duration of mechanical ventilation, duration of oxygen inhaled, hospitalization stay, incidence rate of complications in study group were significantly lower than those in control group, and the differences were significance (P<0.05). Conclusions Compared with CMV or SIMV combined with PS, NCPAP combined with PS could diminish duration of mechanical ventilation, duration of oxygen inhaled, hospitalization stay, and reduce incidence rate of complications without increasing their mortality. Whether NCPAP is a better lung protective ventilation mode for preterm infants with NRDS or not, there still needs large-scale randomized controlled multi-center clinical trials to prove. Key words: Pulmonary surfactants; Respiratory distress syndrome, newborn; Ventilators, mechanical; Nasal continuous positive airway pressure; Infant, premature