RESUMO
BACKGROUND: Extremely low birth weight (ELBW) infants are at increased risk for invasive candidiasis and associated morbidity and mortality. The use of fluconazole prophylaxis in this population has raised a benefit versus risk concern among clinicians. OBJECTIVES: To evaluate the effectiveness and safety of fluconazole prophylaxis in ELBW infants. STUDY DESIGN: ELBW infants (BWAssuntos
Antibioticoprofilaxia
, Antifúngicos/efeitos adversos
, Candidíase/epidemiologia
, Candidíase/prevenção & controle
, Colestase/induzido quimicamente
, Fluconazol/efeitos adversos
, Recém-Nascido de muito Baixo Peso
, Fosfatase Alcalina/sangue
, Antifúngicos/administração & dosagem
, Antifúngicos/uso terapêutico
, Bilirrubina/sangue
, Candidíase/etiologia
, Estudos de Casos e Controles
, Colestase/sangue
, Feminino
, Fluconazol/administração & dosagem
, Fluconazol/uso terapêutico
, Humanos
, Recém-Nascido
, Doenças do Prematuro/epidemiologia
, Doenças do Prematuro/etiologia
, Doenças do Prematuro/prevenção & controle
, Masculino
, New Jersey/epidemiologia
, Estudos Retrospectivos
RESUMO
OBJECTIVE: To compare the work of breathing (WOB) in premature neonates supported with high-flow nasal cannula (HFNC) and nasal continuous positive airway pressure (NCPAP). STUDY DESIGN: Eighteen preterm neonates <2.0 kg on HFNC or NCPAP support were studied in a random order. A ventilator was used to deliver 6 cm H2O of NCPAP with nasal prongs. High-flow nasal cannula delivered with Vapotherm (VAPO) at 3, 4 and 5 l/min was used. Tidal ventilation was obtained using respiratory inductance plethysmography calibrated with face-mask pneumotachography. An esophageal balloon estimated pleural pressure from which changes in end distending pressure were calculated. Inspiratory, elastic and resistive WOB and respiratory parameters were calculated. RESULTS: No differences were found in the WOB for all settings. Changes in end distending pressure did not vary significantly over all device settings except VAPO at 5 l/min. CONCLUSION: In these preterm infants with mild respiratory illness, HFNC provided support comparable to NCPAP.