关键词: 先天性心脏病, 外科手术, 无创正压通气, 湿化温度, 呼吸功能, 儿童

Abstract: Objective　To explore the effects of 37 ℃ intubation humidification versus 34 ℃ mask humidification on respiratory function and complications in children undergoing non-invasive positive pressure ventilation (NPPV) after congenital heart disease (CHD) surgery. Methods　One hundred and ten children undergoing NPPV after CHD surgery at Pediatric Intensive Care Unit, Guangdong Provincial People's Hospital, Southern Medical University from January 2023 to January 2025 were selected for the randomized controlled trial, including 57 boys and 53 girls who were 11.00 (4.00, 14.00) months old. They were divided into Group A, taking 37 ℃ intubation humidification, and Group B, taking 34 ℃ mask humidification, by the random number table method, with 55 cases in each group. Both groups used the Fisher & Paykel MR850 humidifier to humidify their air tracts. The general data, complications (sputum viscosity, nasal bleeding, oropharyngeal dryness, etc.), and treatment effects [suction frequency, stuffy nose ventilation time, satisfaction rate with air tract humidification, comfort degree, and partial pressures of oxygen (PaO2), partial pressures of carbon dioxide (PaCO2), and oxygenation indexes (PaO2/FiO2) after 30 minutes' and 12 hours' ventilation] were compared between the two groups.The t test, non-parameter test, and χ2 test were used for the statistical analyses. Results　There were no statistical differences in the general data between the two groups (all P>0.05). The incidence rates of sputum viscosity, nasal bleeding, and oropharyngeal dryness in Group A were lower than those in Group B (all P<0.05). The stuffy nose ventilation time and ICU stay in Group A were shorter than those in Group B [49.0 (30.0, 77.0) h vs. 72.0 (44.0, 112.0) h and 16.0 (12.0, 22.0) d vs. 21.0 (14.0, 26.0) d]; the suction frequency in Group A was lower than that in group B [4 (1, 8) times/d vs. 8 (6, 8) times/d]; the satisfaction rate with air tract humidification and comfort score in Group A were higher than those in Group B [87.3% (48/55) vs. 9.1% (5/55) and 82.0±8.87 vs. 76.0±9.89]; there were statistical differences (all P<0.05). After 30 minutes' ventilation, there were no statistical differences in PaCO2, PaO2, and PaO2/FiO2 between the two groups (all P>0.05). After 12 hours' ventilation, the PaCO2 in Group A was lower than that in Group B [40 (36, 47) mmHg (1 mmHg=0.133 kPa) vs. 49 (45, 55) mmHg, P<0.05]; there were no statistical differences in PaO2 and PaO2/FiO2 between the two groups (both P>0.05). Conclusion　Application of 37 ℃ intubation humidification in children undergoing NPPV after CHD surgery can reduce sputum viscosity and respiratory tract complications, improve their respiratory function, satisfaction with air tract humidification, and comfort, shorten ventilator time and ICU stay, and promote their recovery.

Key words: Congenital heart disease, Surgery, Non-invasive positive pressure ventilation, Humidification temperature, Respiratory function, Child