Respiratory support in premature infants in the intensive care unit

Abstract

Objective - to assess the impact of a non-invasive approach to mechanical ventilation (ALV) and compare the intubation rate, the use of exogenous surfactants and the duration of hospitalization, the incidence of complications in preterm infants with a gestational age of 28 to 32 weeks using the "early CPAP" protocol and without. Materials and methods. A retrospective analysis of the cards of 240 children aged ≤35 weeks was carried out. Various methods of artificial lung ventilation were used in the intensive care unit. A prospective analysis of the use of the "early CPAP" protocol was carried out in 46 newborns of gestational age 28-32 weeks, the results of which were compared with the data of 30 newborns of comparable age (comparison group) who received intensive therapy not according to the "early CPAP" protocol. Results. A retrospective analysis showed
that at <28 weeks of prematurity, two-level nasal CPAP was the main regimen used. In preterm infants at 28-31 weeks, continuous positive airway pressure was often used through nasal cannulas. Premature infants aged 32 to 35 weeks used moistened and warm high-flow nasal prongs the longest. Prospective analysis Significant differences between the main group and the control group in terms of the frequency of intubation (p=0.006), the number of days of invasive mechanical ventilation (p=0.013), the use of surfactant (p=0.035), the days of hospital stay (p=0.023) and the rate of complications (p=0.026). Conclusion The results of the study confirm the benefits of using early CPAP and point to an innovative aspect, namely its use for preterm infants between 28 and 32 weeks’ gestational age, in addition to the use of short binasal prongs as an interface of
choice and intermediate levels of CPAP.