PDF(Pubmed)
Abstract：
In South Africa, prematurity stands as one of the foremost causes of neonatal mortality. A significant proportion of these deaths occur because of respiratory distress syndrome of prematurity. The implementation of non-invasive respiratory support, such as continuous positive airway pressure (CPAP), has demonstrated both safety and efficacy in reducing mortality rates and decreasing the need for mechanical ventilation. Given the absence of blood gas analysers and limited radiological services in many district hospitals, the severity of respiratory distress is often assessed through observation of the infant\'s work of breathing and the utilisation of bedside scoring systems. Based on the work of breathing, non-invasive therapy can be commenced timeously. While evidence supporting the use of high-flow nasal cannula as a primary treatment for respiratory distress syndrome remains limited, it may be considered as an alternative, provided that CPAP machines are available. The purpose of this article is to advocate the use of non-invasive therapy in low resource-limited settings and describe the indications, contraindications, complications, and application of CPAP therapy. This would benefit healthcare workers, especially in low-care settings and district hospitals.
摘要：
在南非,早产是新生儿死亡的首要原因之一。这些死亡中有很大一部分是由于早产儿的呼吸窘迫综合征。实施无创呼吸支持，如持续气道正压通气(CPAP)，已证明在降低死亡率和减少机械通气需求方面具有安全性和有效性。鉴于许多地区医院没有血气分析仪和有限的放射服务，呼吸窘迫的严重程度通常是通过观察婴儿的呼吸功能和床边评分系统的使用来评估的。基于呼吸的工作，非侵入性治疗可以及时开始。虽然支持使用高流量鼻插管作为呼吸窘迫综合征的主要治疗方法的证据仍然有限，它可以被认为是一种替代方案，前提是CPAP机器可用。本文的目的是倡导在低资源有限的环境中使用非侵入性治疗，并描述适应症，禁忌症,并发症,以及CPAP治疗的应用。这将使医护人员受益，特别是在低护理环境和地区医院。
