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Rostoker H, Guillois B, Caradec A, Lecomte F, Oriot D, Chollat C. Creation of a rating scale to teach Less Invasive Surfactant Administration (LISA) in simulation. BMC Med Educ 2024; 24:146. [PMID: 38355497 PMCID: PMC10868031 DOI: 10.1186/s12909-024-05118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Simulation-based training is gaining increasing prominence in neonatology training. The Less Invasive Surfactant Administration (LISA) method is starting to be taught in simulation. The aim of this educational study was to develop and validate a rating scale for teaching the LISA method in simulation. METHODS The Downing framework was used to create this performance-rating scale. A first version of the scale was submitted to 12 French and Belgian experts to obtain their opinions. Consensus was reached using a modified Delphi method. The performance of 40 pediatricians was then evaluated with this scale on a preterm neonate manikin simulating a neonatal respiratory distress syndrome. Each run was evaluated using the scale by two independent observers based on video recordings. RESULTS The Cronbach alpha score of the rating scale was 0.72. The intraclass correlation coefficient (ICC) was 0.91 and the scores between raters were not significantly different. Finally, this rating scale correctly distinguished the experienced from the inexperienced learners (p < 0.01). CONCLUSIONS This rating scale is one of the first rating scales for the evaluation and teaching of the LISA method in simulation. This tool has ample potential for use in clinical practice to evaluate the performance of surfactant administration in preterm neonates.
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Affiliation(s)
- Hélène Rostoker
- Sorbonne Université, Department of Neonatal Paediatrics, Trousseau Hospital, APHP, F-75012, Paris, France
| | - Bernard Guillois
- Normandie Simulation Center in Health Care (NorSimS), 14033, Caen, France
- Université Caen Normandie, 14032, Caen, France
| | - Amaya Caradec
- P2ULSE, Hôpital Trousseau, APHP centre - Sorbonne Université, Paris, France
| | - François Lecomte
- Service des urgences de l'hôpital Cochin, APHP centre, Université de Paris Cité, Paris, France
| | - Denis Oriot
- ABS Lab, Simulation Laboratory, Faculty of Medicine of Poitiers, Poitiers, France
| | - Clément Chollat
- Sorbonne Université, Department of Neonatal Paediatrics, Trousseau Hospital, APHP, F-75012, Paris, France.
- Université Paris Cité, Inserm, NeuroDiderot, F-75019, Paris, France.
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Huang Y, Zhao J, Hua X, Luo K, Shi Y, Lin Z, Tang J, Feng Z, Mu D. Guidelines for high-flow nasal cannula oxygen therapy in neonates (2022). J Evid Based Med 2023; 16:394-413. [PMID: 37674304 DOI: 10.1111/jebm.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
High-flow nasal cannula (HFNC) oxygen therapy, which is important in noninvasive respiratory support, is increasingly being used in critically ill neonates with respiratory failure because it is comfortable, easy to setup, and has a low incidence of nasal trauma. The advantages, indications, and risks of HFNC have been the focus of research in recent years, resulting in the development of the application. Based on current evidence, we developed guidelines for HFNC in neonates using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The guidelines were formulated after extensive consultations with neonatologists, respiratory therapists, nurse specialists, and evidence-based medicine experts. We have proposed 24 recommendations for 9 key questions. The guidelines aim to be a source of evidence and reference of HFNC oxygen therapy in clinical practice, and so that more neonates and their families will benefit from HFNC.
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Affiliation(s)
- Yi Huang
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
| | - Jing Zhao
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| | - Xintian Hua
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| | - Keren Luo
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| | - Yuan Shi
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
| | - Zhenlang Lin
- Department of Neonatology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Jun Tang
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
| | - Zhichun Feng
- Department of Neonatology, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing, P.R. China
| | - Dezhi Mu
- Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, P.R. China
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Mowitz ME, Gao W, Sipsma H, Zuckerman P, Wong H, Ayyagari R, Sarda SP, Siffel C. Long-term burden of respiratory complications associated with extreme prematurity: An analysis of US Medicaid claims. Pediatr Neonatol 2022; 63:503-11. [PMID: 35817695 DOI: 10.1016/j.pedneo.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Infants born extremely premature (EP) (<28 weeks gestational age) are at high risk of complications, particularly bronchopulmonary dysplasia (BPD), which can develop into chronic lung disease (CLD). METHODS The burden of respiratory complications in EP infants up to 2 years corrected age (CA) was evaluated using real-world data from the US Medicaid program. Data recorded between 1997 and 2018 on EP infants without major congenital malformations were collected from Medicaid records of six states. EP infants were divided into three cohorts: BPD, CLD, and without BPD or CLD. The incidence of respiratory conditions, respiratory medication use, and healthcare resource utilization were compared between the BPD cohort and CLD cohort versus the cohort without BPD or CLD, using unadjusted and adjusted generalized linear models. RESULTS A total of 4462 EP infants were identified (17.4% of all premature infants in the database). Of these, BPD and CLD were diagnosed in 61.9% and 72.1%, respectively, and 14.5% were diagnosed with neither BPD nor CLD. Compared with infants without BPD or CLD, infants with BPD or CLD had more complications and a longer length of birth hospitalization stay. Respiratory distress syndrome was the most frequently reported complication (94.6%, 92.5%, and 82.3% of EP infants in the BPD, CLD, and without BPD or CLD cohorts, respectively). After the birth hospitalization, respiratory conditions, respiratory medication use, and incidence rates of rehospitalizations, emergency room visits, and outpatient visits were higher for infants with BPD or CLD. Rehospitalization occurred in 50.5%, 51.6%, and 27.3% of EP infants with BPD, CLD, or without BPD or CLD, respectively; most hospitalizations occurred for respiratory-related reasons. CONCLUSION In this analysis of a large population of EP infants up to 2 years CA, respiratory conditions were prevalent after the birth hospitalization and were associated with high rates of medication and healthcare resource utilization.
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Yuan Y, Chen Y, Zhou L, Liu W, Dai Z. Gas Exchange Mechanism of High Frequency Ventilation: A Brief Narrative Review and Prospect. J Shanghai Jiaotong Univ Sci 2022; 28:1-5. [PMID: 35600242 PMCID: PMC9109743 DOI: 10.1007/s12204-022-2424-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023]
Abstract
The high frequency ventilation (HFV) can well support the breathing of respiratory patient with 20%-40% of normal tidal volume. Now as a therapy of rescue ventilation when conversional ventilation failed, the HFV has been applied in the treatments of severe patients with acute respiratory failure (ARF), acute respiratory distress syndrome (ARDS), etc. However, the gas exchange mechanism (GEM) of HFV is still not fully understood by researchers. In this paper, the GEM of HFV is reviewed to track the studies in last decades and prospect for the next likely studies. And inspired by previous studies, the GEM of HFV is suggested to be continually developed with various hypotheses which will be testified in simulation, experiment and clinic trail. One of the significant measures is to study the GEM of HFV under the cross-disciplinary integration of medicine and engineering. Fully understanding the GEM can theoretically support and expand the applications of HFV, and is helpful in investigating the potential indications and contraindications of HFV.
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Affiliation(s)
- Yueyang Yuan
- School of Mechanical and Electrical Engineering, Hunan City University, Yiyang, Hunan, 413099 China
| | - Yuqing Chen
- Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai, 200030 China
| | - Li Zhou
- School of Mechanical and Electrical Engineering, Hunan City University, Yiyang, Hunan, 413099 China
| | - Wei Liu
- Hunan Micomme Medical Technology Development Co., Ltd., Changsha, 410205 China
| | - Zheng Dai
- Hunan Micomme Medical Technology Development Co., Ltd., Changsha, 410205 China
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Losada OR, Ramón AM, Fernández AG, España VF, Turpin AG, Gómez JJC, Salinas FC. Use of high flow nasal cannula in Spanish neonatal units. An Pediatr (Engl Ed) 2022; 96:319-325. [PMID: 35523688 DOI: 10.1016/j.anpede.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The use of high-flow cannula therapy (HFNC) in neonatal units has increased in recent years, but there are no consensus guidelines on its indications and application strategies. Our aim was to know the rate of use of HFNC, their indications and the management variability among Spanish neonatal units. MATERIAL AND METHODS Twenty-five-question survey for medical and nursing staff. Level II and III units were contacted by phone and sent in Google forms between September 2016 and December 2018. RESULTS Ninety-seven responses (63.9% medical, 36.1% nursing), from 69 neonatal units representing 15 autonomous communities (87% level of care III; 13% level II). All units except one have HFNC with a humidified and heated system. Their most frequent indications are: non-invasive ventilation weaning (79.4%), bronchiolitis (69.1%), respiratory distress of the term newborn (58.8%), after extubation (50.5%). Minimum flow (1-5 L/min) and maximum flow (5-15 L/min) are variable between units. 22.7% have experienced some adverse effect from its use (9 air leak, 12 nasal trauma). Less than half have an employment protocol, but all the answers agree on the usefulness of national recommendations. CONCLUSIONS HFNC therapy is widely used in Spanish units, but there is great variability in its indications and strategies of use. National recommendations would be applicable in most units and would allow unifying its use.
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Luo K, Huang Y, Xiong T, Tang J. High-flow nasal cannula versus continuous positive airway pressure in primary respiratory support for preterm infants: A systematic review and meta-analysis. Front Pediatr 2022; 10:980024. [PMID: 36479290 PMCID: PMC9720183 DOI: 10.3389/fped.2022.980024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Respiratory support is crucial for the survival of preterm infants, and High-flow Nasal Cannula Oxygen Therapy (HFNC) and Continuous Positive Airway Pressure (CPAP) are commonly used for neonatal respiratory support. This meta-analysis aimed to compare the effects of HFNC and CPAP in primary respiratory support for preterm infants, to provide evidence-based support for clinical practice. PubMed, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, VIP, WANFANG and SinoMed were searched for eligible studies. The primary outcomes included the incidence of treatment failure and the application of mechanical ventilation. A total of 27 eligible studies with 3,351 participants were included. There was no significant difference in the incidence of respiratory support failure [RR = 1.17, 95%CI (0.88-1.56)] and the application of mechanical ventilation [RR = 1.00, 95%CI (0.84-1.19)] between HFNC group and CPAP group. HFNC resulted in lower rate of air leaks [RR = 0.65, 95%CI (0.46-0.92)], nasal trauma [RR = 0.36, 95%CI (0.29-0.45)] and abdominal distension [RR = 0.39, 95%CI (0.27-0.58)], and later time of mechanical ventilation initiating [SMD = 0.60, 95%CI (0.21-0.99)], less duration of oxygen therapy [SMD = -0.35, 95%CI (-0.68 to -0.02)] and earlier enteral feeding [SMD = -0.54, 95%CI (-0.95 to -0.13)]. Alternative non-invasive respiratory support after initial treatment failure resulted in no difference in the application of mechanical ventilation between the two groups [RR = 0.99, 95%CI (0.52-1.88)]. HFNC might be more effective and safer in primary respiratory support for preterm infants. Using CPAP as a remedy for the treatment failure of HFNC could not avoid intubation. For premature infants with the gestational age <28 weeks, HFNC as primary respiratory support still needs to be further elucidated. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022313479, identifier: CRD42022313479.
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Affiliation(s)
- Keren Luo
- Department of Neonatology, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Yi Huang
- Department of Neonatology, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Tao Xiong
- Department of Neonatology, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Jun Tang
- Department of Neonatology, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
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Dani C. Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula Today. Clin Perinatol 2021; 48:711-724. [PMID: 34774205 DOI: 10.1016/j.clp.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study reviews the mechanisms of action and physiologic effects of nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC) in preterm infants with respiratory distress syndrome, discusses the main characteristics of available devices and patients' interfaces, reports on risk of failure and possible adverse effects, and summarizes clinical evidence regarding effectiveness for preventing mechanical ventilation as primary respiratory support or after extubation in the neonatal intensive care unit. nCPAP is preferred to HFNC as primary mode of noninvasive respiratory support in preterm infants with respiratory distress syndrome, whereas HFNC is an effective alternative to nCPAP after extubation.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy; Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
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Rodriguez Losada O, Montaner Ramón A, Gregoraci Fernández A, Flores España V, Gros Turpin A, Comuñas Gómez JJ, Castillo Salinas F. [Use of high flow nasal cannula in Spanish neonatal units]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00145-4. [PMID: 33771459 DOI: 10.1016/j.anpedi.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION The use of high-flow cannula therapy (HFNC) in neonatal units has increased in recent years, but there are no consensus guidelines on its indications and application strategies. Our aim was to know the rate of use of HFNC, their indications and the management variability among Spanish neonatal units. MATERIAL AND METHODS Twenty-five-question survey for medical and nursing staff. Level II and III units were contacted by phone and sent in Google forms between September 2016 and December 2018. RESULTS Ninety-seven responses (63.9% medical, 36.1% nursing), from 69 neonatal units representing 15 autonomous communities (87% level of care III; 13% level II). All units except one have HFNC with a humidified and heated system. Their most frequent indications are: non-invasive ventilation weaning (79.4%), bronchiolitis (69.1%), respiratory distress of the term newborn (58.8%), after extubation (50.5%). Minimum flow (1-5 L/min) and maximum flow (5-15 L/min) are variable between units. 22.7% have experienced some adverse effect from its use (9 air leak, 12 nasal trauma). Less than half have an employment protocol, but all the answers agree on the usefulness of national recommendations. CONCLUSIONS HFNC therapy is widely used in Spanish units, but there is great variability in its indications and strategies of use. National recommendations would be applicable in most units and would allow unifying its use.
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袁 越, 周 理, 刘 炜, 戴 征, 陈 宇. [Prospects and developments in the technologies of high frequency oscillatory ventilation]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2021; 38:185-190. [PMID: 33899444 PMCID: PMC10307566 DOI: 10.7507/1001-5515.202003072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/27/2020] [Indexed: 11/03/2022]
Abstract
The high frequency oscillatory ventilation (HFOV) is characterized with low tidal volume and low mean airway pressure, and can well support the breathing of the patients with respiratory diseases. Since the HFOV was proposed, it has been widely concerned by medical and scientific researchers. About the HFOV, this paper discussed its current research status and prospected its future development in technologies. The research status of ventilation model, mechanisms and ventilation mode were introduced in detail. In the next years, the technologies in developing HFOV will be focused on: to develop the branched high-order nonlinear or volume-depended resistance-inertance-compliance (RIC) ventilation model, to fully understand the mechanisms of HFOV and to achieve the noninvasive HFOV. The development in technologies of HFOV will be beneficial to the patients with respiratory diseases who failed with conventional mechanical ventilation as one of considerable ventilation methods.
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Affiliation(s)
- 越阳 袁
- 湖南城市学院 机电工程学院(湖南益阳 413099)School of Mechanical and Eectrical Engineering, Hunan City University, Yiyang, Hunan 413099, P.R.China
| | - 理 周
- 湖南城市学院 机电工程学院(湖南益阳 413099)School of Mechanical and Eectrical Engineering, Hunan City University, Yiyang, Hunan 413099, P.R.China
| | - 炜 刘
- 湖南明康中锦医疗科技发展有限公司(长沙 410000)Hunan Micomme Medical Development Co., Ltd, Changsha 410000, P.R.China
| | - 征 戴
- 湖南明康中锦医疗科技发展有限公司(长沙 410000)Hunan Micomme Medical Development Co., Ltd, Changsha 410000, P.R.China
| | - 宇清 陈
- 上海市胸科医院 呼吸内科(上海 200030)Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai 200030, P.R.China
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Szczapa T, Hożejowski R, Krajewski P. Implementation of less invasive surfactant administration in clinical practice-Experience of a mid-sized country. PLoS One 2020; 15:e0235363. [PMID: 32628732 PMCID: PMC7337349 DOI: 10.1371/journal.pone.0235363] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/13/2020] [Indexed: 11/18/2022] Open
Abstract
Objective There are differences in the adoption rates of less invasive surfactant administration (LISA) worldwide. We aimed to describe and analyze the process of LISA introduction at the country level. Methods A standardized training program (33 courses covering >500 neonatologists) was followed by a cohort study. Data regarding consecutive LISA procedures were acquired over 12 months in 31 tertiary neonatal centers, using a dedicated on-line platform. Results Of 500 LISA procedures, 75% were performed by specialists and 25% by residents. The mean percentage share of LISA in all surfactant therapies was 24%, which represents a 6-fold increase compared to previous years. After 12 months, 76% of the procedures were rated “easy/very easy” vs 59% at baseline (p<0.05). Surfactant re-treatment rate was 15%. Twenty-three percent of infants required mechanical ventilation within 72 hours of life. Oxygen desaturation and surfactant reflux were the most frequent complications. Unlike previous reports describing exclusive use of nasal continuous positive airway pressure (nCPAP) during LISA, majority of procedures (63%) were carried out using nasal intermittent positive pressure ventilation (NIPPV) or Bilevel Positive Airway Pressure (BiPAP). Efficacy of LISA with NIPPV or BiPAP was not significantly different from that with nCPAP (22.4% vs 24.5% of cases requiring intubation). Ventilation was provided with nasal cannulas or nasal masks (90%) and rarely with “RAM” cannulas or nasopharyngeal tubes. Rigid catheters were preferred (88.4%); tracheal insertion was successful at first attempt in 87% of cases. Majority of infants (79%) received no premedication prior to the procedure and almost all were given caffeine citrate. Median time of instillation was 1.5 minutes. Conclusions The LISA procedure does not appear to be technically difficult to master. Training combining theory with practical exercises is an efficient implementation strategy. Variations in adoption rates indicate the need for additional, more personalized teachings in some centers.
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Affiliation(s)
- Tomasz Szczapa
- Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
- * E-mail:
| | | | - Paweł Krajewski
- Department of Neonatology, University Center for Mother and Newborn’s Health, Warsaw, Poland
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He MY, Lin XZ. [Research advances in the methods for weaning from high-frequency oscillatory ventilation in neonates]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:1234-1238. [PMID: 31874666 PMCID: PMC7389009 DOI: 10.7499/j.issn.1008-8830.2019.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
Neonatal respiratory failure is a serious clinical illness commonly seen in the neonatal intensive care unit (NICU). Although clinicians want to maximize noninvasive respiratory support, some low-birth-weight preterm infants may require invasive respiratory support from the beginning. As an important respiratory management technique for the treatment of respiratory failure, high-frequency oscillatory ventilation (HFOV) allows gas exchange by rapid delivery at a tidal volume lower than or equal to anatomy death volume. Continuous distending pressure was applied to achieve uniform lung expansion, reduce repeated contraction of lung tissue, and exert a protective effect on lung tissue, and so it is preferred by clinicians and has been widely used in clinical practice. However, no consensus has been reached on the methods for weaning from HFOV. This article reviews the methods for weaning from HFOV, so as to provide help for clinical practice.
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Affiliation(s)
- Ming-Yuan He
- Department of Neonatology, Xiamen Maternal and Child Care Hospital, Xiamen, Fujian 361001, China.
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