인공호흡기 가습기 적용방법이 초극소 저출생 체중아의 경비지속 기도 양압 환기법 유지기간에 미치는 영향
Effect of Optimal Humidification for Extremely Low Birth Weight Infants During Nasal Continuous Positive Airway Pressure
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초록
본 연구는 ELBWI를 대상으로 nCPAP 시 적정습도 제공이 nCPAP 유지기간에 미치는 효과를 검증하였다 적정습도(37˚C, 44 mg/L, 100%)를 제공 시 nCPAP 유지기간, 재삽관율, 비강점막상태를 분석하였다. 실험군이 대조군대비 첫 번째 nCPAP 유지기간(14.6일, p< .001), 총 입원기간 동안 nCPAP 유지기간(7.6일, p=.004)이 향상되었다. 또한 재삽관율도 70.7%에서 40.2%로 감소되었다(p<.001). 재삽관의 원인은 비강상태 변화가 가장 많았으며 코 막힘이 대조군은 25명(21.6%)이었으나 실험군은 8명(7.8%)으로 감소되었다(p=.005). nCPAP 적용 후 비강상태 변화는 대조군은 5.5일이었으나 실험군 9.5일로 향상되었다(p=.004). 이상의 결과를 토대로 적정습도 제공은 nCPAP 유지기간을 향상시켜 침습적 기도 삽관을 감소시킴으로써 ELBWI의 호흡기계 합병증 감소에 기여할 것으로 분석된다.
Abstract
Purpose: To evaluate the efficacy of Optimal humidification during Nasal Continuous Positive Airway Pressure (nCPAP) for Extremely Low Birth Weight Infant (ELBWI). Methods: The study design was a pre-test-post-test nonequivalent nonsynchronized quasi-experimental design. The participants were 218 ELBWI on nCPAP (experimental group: 102 and control group: 116). Data collection was conducted from January 2005 to April 2010. In order to measure and analyze the nCPAP duration, reintubation and nasal condition, Chi-square test and t-test were used. Results: Hypothesis 1, that the duration with nCPAP in the experimental group is longer than that of the control group and hypothesis 2-3, that the rate of reintubation and nasal problems in the experimental group are lower than the control group, were all supported as there were statistically significant differences between two groups. Conclusion: The findings suggest that the Optimal humidification in this study is an efficient intervention because it helps increase the last time of nCPAP with ELBWI and minimize complications. It is expected that Optimal humidification is beneficial and helpful in preventing and caring for respiratory problems in these infants.
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