nCPAP transfer

Noninvasive respiratory support is a crucial component of neonatal respiratory distress syndrome therapy. The nCPAP (nasal continuous positive airway pressure) is recommended as an initial for respiratory support of a premature baby. However, there is no consensus in the literature on the possibility, conditions and criteria for non-invasive respiratory support for newborns during inter-hospital transportation, and the recommendations are empirical. Objective: To study the possibility of carrying out nCPAP during pre-transport preparation and inter-hospital transportation of newborns. Materials and Methods: the observational, cohort, retrospective study included data on 70 cases of evacuation of newborns performed by the transport team of the resuscitation advisory Center of the Regional Children's Clinical Hospital of Yekaterinburg in the period from July 1, 2014 to December 31, 2018 to patients who were on noninvasive ventilation (nCPAP) at the time of examination by the transport team in the initial medical organization. The initial sample was divided into a group of patients transported to a ventilator (n=22) and a group of patients transported to nCPAP (n=47), respiratory support was discontinued in one case. Results: analyzing the parameters of respiratory support at the time of examination by the transport team, statistically significant differences were observed between the oxygen fraction groups (34% (30-45) and 30% (21-30), the first and second groups, respectively, p=0.002) and the saturation index of oxygenation (2.14 (1.55 - 2.58) and 1.53 (1.31 - 1.84)) the first and second groups, respectively, p = 0.001). The saturation index of oxygenation has an acceptable predictive value in for tracheal intubation at the stage of pre–transport preparation (AUC 0.799 [0.682 - 0.917]). During transportation, one patient of the second group required tracheal intubation (2,13%[0,05 - 11,29]). Upon admission, one patient of the second group needed to perform tracheal intubation (2,17%[0,06 – 11,53]), no other correction of the parameters of noninvasive support was required for patients of the second group. Conclusion: The main criterion for the transfer to a ventilator at the stage of pre-transport preparation is the dependence on additional oxygen during the nCPAP. The saturation oxygenation index (AUC 0.799 [0.682 – 0.917]) and the SpO2/FiO2 ratio (0.803 [0.687 – 0.919]) have an acceptable predictive value in relation to the need for tracheal intubation. T