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THE SIGNIFICANCE OF NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE (N-CPAP) VENTILATION IN TREATING SEVERE HEART FAILURE FOR CHILDREN HAVING CONGENITAL HEART DISEASE (CHD) WITH INCREASED PULMONARY BLOOD FLOW
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Abstract
Objective: The study aims to investigate the role of N-CPAP ventilation in treating severe heart failure for children having CHD with increased pulmonary blood flow. Methods: A one-group quasi-experimental study design was employed to examine the effectiveness of N-CPAP ventilation on the treatment of severe heart failure for a convenience sample of 42 eligible children from August 2021 to July 2022. All children (ages ranging from 2 months to 16 years of age) who had a diagnosis of severe heart failure (class IV) caused by CHD with increased pulmonary blood flow received treatment-CPAP ventilation at Heart Center, the National Children's Hospital. Results: Among 42 children, ages ranged from 2 months to 16 years of age with the mean age at 5.49 months (SD = 4.6). The mean weight of these children (n=42) was 8.32 kg (SD = 5.67). Children with ventricular septal defect (n = 14) held the largest propotion with 33.2%. About 29 children (69%) had their heart failure successfully treated using N-CPAP ventilation in compared to a number of 13 children (31%) who did not recover from the administration of this treatment. The children who had successful treatment using N-CPAP ventilation had shorter mean hospital stay (M = 7.26, SD = 5.67) than those did not (M = 14.2, SD = 2.8). The percentage of children with severe heart failure after the administration of N-CPAP ventilation dramatically decreased from 100% to 21.4%. There were significant drops of heart rate (p<.01), respiratory rate (p<.01), oxygen saturation (p<.01) and pH (p<.001) in this population before and after the application of N-CPAP ventilation. Only seven children (16.7%) and about five children (11.9%) presented with mild complications of N-CPAP ventilation, including nasal pressure ulcer and abdominal distension,. Conclusions: The administration of N-CPAP ventilation may contribute to the improvement of clinical symptoms of severe heart failure among children having CHD with increased pulmonary blood flow.
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Keywords
severe heart failure, Nasal Continuous Positive Airway Pressure, children, congenital heart failure and increased pulmonary blood flow.
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