Effect of the nasal continuous positive airway pressure combined with small dose of corticosteroid on the blood gas index and inflammatory cytokine level in children with severe pneumonia

Objective:To observe the effects of the nasal continuous positive airway pressure(CPAP) combined with small dose of corticosteroid on the blood gas index and inflammatory cytokine level in children with severe pneumonia.Methods:Seventy-eight children with severe pneumonia were divided into the observation group and control group according to the different treatment(39 cases each group).Two groups were treated with the conventional PICU ward care and drug treatment after admission,and the observation group and control group were additionally treated with the nasal CPAP combined with small dose of glucocorticoid and conventional nasal catheter oxygen intake,respectively.The changes of the blood gas index and inflammatory cytokine level in two groups between before and after treatment were compared.Results:After treatment,the levels of PaO₂,SaO₂ and pH significantly increased,and the level of PaCO₂ significantly decreased in two groups compared before treatment(P<0.01).After treatment,the levels of PaO₂ and SaO₂ and pH in observation group were significantly higher than those in control group,and the PaCO₂ level in observation group was significantly lower than that in control group(P<0.01).After treatment,the level of IL-10 significantly increased,and the levels of CRP,TNF-α and sICAM-1 significantly decreased in two groups compared before treatment(P<0.01).After treatment,the levels of IL-10,CRP,TNF-α and sICAM-1 in observation group were significantly higher than those in control group(P<0.01).Conclusions:The nasal CPAP combined with small dose of corticosteroid in the treatment of severe pneumonia can improve the hypoxia and restore the acid-base balance by regulating the related inflammatory cytokine level in the short-term,which is superior to the conventional treatment.