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Study aim
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comparison of the efficacy of CPAP and HFNC methods in the treatment of Iranian premature infants with RDS
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Design
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Clinical trial with control group, with parallel groups, one blind, randomized
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Settings and conduct
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This randomized control trail study was conducted among 60 infants suffering from RDS in Imam Khomeini Hospital Complex, Valiasr Hospital, in Tehran city, during 2018. Infantsin the neonatal intensive care unit (NICU) of Valiasr Hospital participated in the study.
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Participants/Inclusion and exclusion criteria
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Only the infant’s with mild to moderate RDS, birth weight less than 2000 grams, gestational age less than 34 weeks, respiratory severity between 4 to 7 score, and requires oxygen 60% or less were eligible to participate in this study. As well as, infants who had heart, digestive and respiratory anomalies, intraventricular hemorrhage (IVH) at birth, persistent air leak, sepsis positive at hospitalization in NICU, and Apgar score of less than 5 at 5 minutes were considered to exclusion criteria in this study.
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Intervention groups
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CPAP treatment was 4 to 6 cm water and FIO2 equivalent to 30% to improve respiratory distress and to reduce the need for oxygen for newborns. The positive pressure created by the device for the infants was measured by a manometer at the beginning of the respiratory tube expiratory arm. It should be noted that treatment was carried out on infants in supine position.
Infants in another group were treated with HFNC methods, and this method continued to improve respiratory distress and eliminate the need for oxygen. Oxygen was heated with a blender unit with a temperature of 32 to 35 °C, and the infant’s mouthwaskeptopen during the use of the upper flow. Regulation flow was calculated based on the following formula: flow rate (liters per minute) = weight (kilograms) & 0.86 + 0.92
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Main outcome variables
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treatment of infants with RDS