Objective: To evaluate the effect of bilevel positive airway pressure (BiPAP) and nasal continuous positive airway pressure (NCPAP) in respiratory support after extubation in infants undergoing cardiac surgery. Methods: A total of 83 infants who underwent repair of atrial septal defect (ASD) or ventricular septal defect (VSD) after extubation were randomized to the BiPAP group (n= 42) or the NCPAP group (n= 41) between January 2020 and December 2020. The primary outcomes were the extubation failure rate and the level of PCO2 within 24 h after extubation. Results: The baseline characteristics between the two groups were similar. The introduction of BiPAP for post-extubation respiratory support did not reduce extubation failure rates compared to NCPAP (P>0.05). The PaCO2 level within 48 h was significantly lower in the BiPAP group (P<0.05). Additionally, the PaO2/FiO2 in the BiPAP group was significantly higher than that in the NCPAP group at 6h, 12h and 24h after treatment (P<0.05).There were no statistically significant differences in duaration on NIV, hospital length of stay, total hospital costs in $ and complications between the two groups (P>0.05). Conclusion: The introduction of BiPAP for post-extubation respiratory support did not reduce extubation failure rates versus NCPAP. However, BiPAP was shown to be superior to NCPAP in improving oxygenation and carbon dioxide clearance.
Objective: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery. Method: A total of 61 infants with ARDS were eligible and were randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31) between January 2020 and December 2020. The primary outcomes were the improvement of the arterial blood gas analysis. The incidence of mechanical ventilation duration, length of hospitalization, and the incidence of complications were considered as secondary outcomes. Results: A total of 61 infants completed the study. In HFOV + PS group, the blood gas analysis results were significantly improved (P<0.05), while, duration of mechanical ventilation and length of hospitalization were shorter than CMV + PS group (P<0.05). But the incidences of complications had no statistical significance between the two groups (P>0.05). Conclusions: Compared with the CMV + PS group, HFOV + PS significantly improved the ABG variables and shortened the length of hospitalization and mechanical ventilation in infants with ARDS after cardiac surgery.
Objective: To explore the difference between bilevel positive airway pressure (BiPAP) and nasal continuous positive airway pressure (NCPAP) as respiratory support after extubation in infants underwent cardiac surgery. Methods: A retrospective analysis was performed on 83 infants who underwent repair of atrial septal defect (ASD) or ventricular septal defect (VSD) in our hospital from January 2020 to December 2020. According to ventilation mode, the patients were divided into BiPAP group (n=42) and NCPAP group (n=41). Blood gas index, PaO2/FiO2, non-invasive ventilation time, extubation failure rate, total enteral feeding time, and complications of the two groups were measured before the treatment and at 6 h, 12 h and 24 h after treatment. The two groups were compared using repeated-measure analysis of variance (ANOVA) and t-test analysis. Statistical significance was considered to be P < 0.05. Results: At 6 h, 12 h and 24 h after treatment, PaO2/FiO2 in BiPAP group was significantly higher than that in NCPAP group (P<0.05). At 12 h and 24 h after treatment, PaCO2 in BiPAP group was significantly lower than that in NCPAP group (P<0.05). There was no statistically significant differences in non-invasive ventilation time, extubation failure rate, total enteral feeding time, and complications between the two groups (P>0.05). Conclusion: Both BiPAP and NCPAP can be used to improve the ventilation of infants underwent repair of ASD or VSD, while BiPAP is more beneficial to improve oxygenation and correct carbon dioxide retention.
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