EFICIENCIA DE LA VENTILACIÓN NASOFARÍNGEA EN RECIÉN NACIDOS MENORES DE 32 SEMANAS DE GESTACIÓN

Abstract

The insufficient pulmonary mechanics of the premature new borns, as well as its asynchronous movements, the bad pulmonary compliance, and the deficiency of surfactant factor contribute in the physiopathology of the respiratory difficulty, therefore is necessary the exogenous surfactant application as well the mechanical ventilation, that is not innocuous, since it causes different complications in the new born. An alternative to this ventilation mode is a noninvasive method of ventilatory support like the nasopharyngeal ventilation. Objective: To determinate the efficiency of the nasopharyngeal ventilation in new born less than 32 weeks of gestation based on the time of ventilatory support. Material and methods: A cohort study was realized in new born on the Perinatology National Institute less than of 32 weeks of gestation that were included according the inclusion criteria and assigned to two different methods from ventilation (nasopharyngeal ventilation and intermittent mechanical ventilation), by the attending physician. They were followed with gasometry studies, radiography, ventilatory parameters and fraction inspired of oxygen by 28 days and/or to complete 32 corrected weeks of gestation. Results: In our study we found a diminution on the ventilator time (hours) with the nasopharyngeal ventilation resulting an average 5.3± (2.6) hours against 36.1 ± (34.11) hours in intermittent mechanical ventilation with one p=0.023. We realized test of Mann-Whitney because the variance of the time of ventilation differs from statistically significant way with p= 0.021. The patients with nasopharyngeal ventilation did not develop HIV, against intermittent mechanical ventilation that develop HIV in three. The relative risk to develop brochopulmonar dysplasia is RR (CI 95% 0.31 to 4.07)p=1.00 and to not develop it RR 0.93 (CI 95% 0.46 to 1.9) p=1.00; In the case of necrotizing enterocolitis we found one case in conventional ventilation. For the sepsis development RR 0.45 (CI 95% 0.11 to 1.71) p=0.33. Conclusion: In our study we demonstrated that the nasopharyngeal ventilation is a safe and efficient method for new born less than 32 weeks of gestation, in addition diminishes the time in hours of the ventilatory support compared with the standard method (intermittent mechanical ventilation) marking a statistically significant difference.