PDF(Pubmed)
Abstract：
Background Newborns frequently experience respiratory distress (RD), necessitating preventive management during transportation. The use of Continuous Positive Airway Pressure (CPAP) is crucial in mitigating RD in neonates, particularly during transit. This study aims to assess the feasibility and efficacy of utilizing a RAM cannula (Neotech Products, Valencia, USA) with a T-piece resuscitator to deliver CPAP during neonatal transport. The objective is to evaluate the response of transported neonates to this intervention, including improvements in distress, surfactant requirements, ventilator dependency, and complications. Method and material Neonates with RD qualifying for CPAP support at birth and requiring transport to Neonatal Intensive Care Unit (NICU) care were included. The average duration of transport was 38 minutes (range 12 minutes to 2 hours). RAM cannula with a T-piece resuscitator was used for CPAP delivery during transportation. Vital parameters and interventions were monitored during transit, and outcomes were compared with inborn neonates receiving standard CPAP in the labor room. Results Out of 48 babies, nine babies required surfactant, and four needed invasive ventilation, with three developing a nasal injury. Compared to in-house preterm babies, these babies had more Positive End Expiratory Pressure (PEEP) knob adjustment, desaturation episodes, late surfactant administration, and intubation needs. Conclusion A high-flow nasal cannula combined with a T-piece resuscitator emerges as a promising modality for CPAP delivery during neonatal transportation, demonstrating efficacy with minimal complications.
摘要：
背景新生儿经常经历呼吸窘迫（RD），在运输过程中需要预防性管理。持续气道正压通气（CPAP）的使用对于减轻新生儿的RD至关重要，特别是在运输过程中。本研究旨在评估利用RAM套管的可行性和有效性(NeotechProducts，瓦伦西亚,美国）在新生儿运输期间使用T型复苏器进行CPAP。目的是评估运输新生儿对这种干预的反应，包括改善困境，表面活性剂要求，呼吸机依赖性,和并发症。方法和材料包括具有RD的新生儿，这些新生儿在出生时符合CPAP支持的条件，并需要运送到新生儿重症监护病房（NICU）护理。运输的平均持续时间为38分钟(范围为12分钟至2小时)。在运输过程中，使用带有T型复苏器的RAM套管进行CPAP输送。在运输过程中监测重要参数和干预措施，并将结果与在分娩室接受标准CPAP的新生儿进行比较。结果48名婴儿中，九个婴儿需要表面活性剂，四个人需要有创通气，三个人鼻腔受伤。与内部早产儿相比，这些婴儿有更多的积极呼气末压力（PEEP）旋钮调节，去饱和发作，晚期表面活性剂给药，需要插管。结论高流量鼻插管联合T型复苏器是新生儿转运期间CPAP分娩的一种有前途的方式。证明疗效与最小的并发症。
