{"id":21712,"date":"2022-05-22T05:07:00","date_gmt":"2022-05-21T21:07:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21712"},"modified":"2022-05-22T07:50:27","modified_gmt":"2022-05-21T23:50:27","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%96%b0%e7%94%9f%e5%84%bf%e6%b0%94%e7%ae%a1%e6%8f%92%e7%ae%a1%e6%97%b6%e7%bb%8f%e9%bc%bb%e9%ab%98%e6%b5%81%e9%87%8f%e6%b0%a7%e7%96%97","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21712","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u65b0\u751f\u513f\u6c14\u7ba1\u63d2\u7ba1\u65f6\u7ecf\u9f3b\u9ad8\u6d41\u91cf\u6c27\u7597"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/medical-articles\/original-article\" class=\"\">ORIGINAL ARTICLE<\/a><strong>FREE PREVIEW<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Nasal High-Flow Therapy during Neonatal Endotracheal Intubation<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Kate A. Hodgson, Louise S. Owen, C. Omar F. Kamlin,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med 2022; 386:1627-1637<br \/>DOI: 10.1056\/NEJMoa2116735<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">BACKGROUND<\/h3>\n\n\n\n<p>Neonatal endotracheal intubation often involves more than one attempt, and oxygen desaturation is common. It is unclear whether nasal high-flow therapy, which extends the time to desaturation during elective intubation in children and adults receiving general anesthesia, can improve the likelihood of successful neonatal intubation on the first attempt.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">METHODS<\/h3>\n\n\n\n<p>We performed a randomized, controlled trial to compare nasal high-flow therapy with standard care (no nasal high-flow therapy or supplemental oxygen) in neonates undergoing oral endotracheal intubation at two Australian tertiary neonatal intensive care units. Randomization of intubations to the high-flow group or the standard-care group was stratified according to trial center, the use of premedication for intubation (yes or no), and postmenstrual age of the infant (\u226428 or &gt;28 weeks). The primary outcome was successful intubation on the first attempt without physiological instability (defined as an absolute decrease in the peripheral oxygen saturation of &gt;20% from the preintubation baseline level or bradycardia with a heart rate of &lt;100 beats per minute) in the infant.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">RESULTS<\/h3>\n\n\n\n<p>The primary intention-to-treat analysis included the outcomes of 251 intubations in 202 infants; 124 intubations were assigned to the high-flow group and 127 to the standard-care group. The infants had a median postmenstrual age of 27.9 weeks and a median weight of 920 g at the time of intubation. A successful intubation on the first attempt without physiological instability was achieved in 62 of 124 intubations (50.0%) in the high-flow group and in 40 of 127 intubations (31.5%) in the standard-care group (adjusted risk difference, 17.6 percentage points; 95% confidence interval [CI], 6.0 to 29.2), for a number needed to treat of 6 (95% CI, 4 to 17) for 1 infant to benefit. Successful intubation on the first attempt regardless of physiological stability was accomplished in 68.5% of the intubations in the high-flow group and in 54.3% of the intubations in the standard-care group (adjusted risk difference, 15.8 percentage points; 95% CI, 4.3 to 27.3).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.nejm.org\/do\/10.1056\/NEJMdo006519\/popup\/media\/NEJMdo006519_1200x800.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">CONCLUSIONS<\/h3>\n\n\n\n<p>Among infants undergoing endotracheal intubation at two Australian tertiary neonatal intensive care units, nasal high-flow therapy during the procedure improved the likelihood of successful intubation on the first attempt without physiological instability in the infant. (Funded by the National Health and Medical Research Council; Australian New Zealand Clinical Trials Registry number,&nbsp;<a href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?ACTRN=12618001498280\" target=\"_blank\" rel=\"noreferrer noopener\">ACTRN12618001498280. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ORIGINAL ARTICLEFREE PREVIEW Nasal High-Flow Therapy du [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21712"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21712"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21712\/revisions"}],"predecessor-version":[{"id":21847,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21712\/revisions\/21847"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21712"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21712"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21712"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}