A Study on the Effects of the Early Use of Nasal CPAP in the
Weaning of Mechanical Ventilators

Kim, Yeoung Ju; Jung, Byun Kyung; Lee, Sang Geel

Original Article

Journal of the Korean Pediatric Society 2003;46(12):1200-1206.
Published online December 15, 2003.

A Study on the Effects of the Early Use of Nasal CPAP in the Weaning of Mechanical Ventilators

Yeoung Ju Kim¹, Byun Kyung Jung¹, Sang Geel Lee¹

¹Department of Pediatrics, Fatima Hospital, Daegu, Korea
¹Department of Pediatrics, Fatima Hospital, Daegu, Korea
¹Department of Pediatrics, Fatima Hospital, Daegu, Korea

인공호흡기 이탈시 비강내 CPAP 조기 사용 효과에 관한 연구

김영주^¹^, 정변경^¹^, 이상길^¹

^¹대구 파티마병원 소아과
^¹대구 파티마병원 소아과
^¹대구 파티마병원 소아과

Correspondence:
Sang Geel Lee, Email: sgleeped@korea.com

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.

Key Words: Moderate respiratory distress syndrome, Nasal continuous positive airway pressure, Intermittent mandatory ventilation, Endotracheal continuous positive airway pressure