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ORIGINAL ARTICLE
Korean J Pediatr 2003 December;46(12) :1200-1206.
A Study on the Effects of the Early Use of Nasal CPAP in the Weaning of Mechanical Ventilators
Yeoung Ju Kim (Kim YJ)1, Byun Kyung Jung (Jung BK)1, Sang Geel Lee (Lee SG)1
1Department of Pediatrics, Fatima Hospital, Daegu, Korea
Corresponding Author: Sang Geel Lee ,Email: sgleeped@korea.com
Copyright © 2003 by The Korean Pediatric Society
ABSTRACT
Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in PaCO2. However, the control group showed a slight CO2 retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.
Keywords: Moderate respiratory distress syndrome | Nasal continuous positive airway pressure | Intermittent mandatory ventilation | Endotracheal continuous positive airway pressure
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