Functional residual capacity and passive compliance measurements after antenatal steroid therapy in preterm infants
Functional residual capacity and passive compliance measurements after antenatal steroid therapy in preterm infants
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DOI：
10.1002/ppul.1070
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发表时间：
2001-06-01
影响因子：
3.1
通讯作者：
Durand, N
中科院分区：
文献类型：
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作者：
McEvoy, C;Bowling, S;Durand, N
对早产动物模型的研究表明，产前皮质类固醇通过改善包括肺容量在内的各种生理变量来促进肺成熟。早产儿接受完整疗程的产前类固醇治疗后肺容量的变化尚未被调查。我们假设一个完整的产前类固醇疗程会显著增加治疗早产儿与未治疗早产儿的功能剩余容量（FRC）。本研究的目的是比较类固醇治疗和未治疗早产儿的FRC和呼吸力学。本研究前瞻性地研究了20名接受了全程产前类固醇治疗的婴儿（妊娠25-34周）和20名匹配的未经治疗的早产儿在36小时内的FRC和被动呼吸力学。采用氮冲洗法测定FRC，采用单次呼吸闭塞法测定呼吸力学。接受类固醇治疗的早产儿（n = 20；平均出生体重= 1,230 g；胎龄= 28.8周）的FRC （29.5 mL/kg vs. 19.3 mL/kg; P < 0.001）明显高于未接受类固醇治疗的早产儿（n = 20；出生体重= 1,202 g；胎龄= 28.5周）。接受治疗的婴儿被动呼吸系统顺应性也高于未接受治疗的婴儿（P < 0.05）。综上所述，与未治疗的早产儿相比，接受完整疗程产前类固醇治疗的早产儿（25-34周妊娠）的FRC和被动呼吸系统依从性显著改善。虽然这项研究不是随机的，但它证实了产前类固醇对肺功能有重要影响，可能有助于降低治疗早产儿呼吸窘迫综合征的风险。(C) 2001 Wiley-Liss, Inc。
Studies in preterm animal models have shown that antenatal corticosteroids enhance lung maturation by improving a variety of physiologic variables, including lung volumes. Changes in lung volume of preterm infants treated with a full course of antenatal steroids have not been investigated. We hypothesized that a full course of antenatal steroids would significantly increase functional residual capacity (FRC) in treated vs, untreated preterm infants. The objective of our study was to compare FRC and respiratory mechanics in steroid treated vs. untreated preterm infants. FRC and passive respiratory mechanics were prospectively studied within 36 hr of life in 20 infants (25-34 weeks of gestation) who had received a full course of antenatal steroids and in 20 matched untreated preterm infants. FRC was measured with the nitrogen washout method, and respiratory mechanics with the single-breath occlusion technique.Preterm infants who received steroids (n = 20; mean birth weight = 1,230 g; gestational age = 28.8 weeks) had a significantly higher FRC (29.5 vs. 19.3 mL/kg; P < 0.001) than un treated infants (n = 20; birth weight = 1,202 g; gestational age = 28.5 weeks). Passive respiratory system compliance was also increased in treated vs. untreated infants (P < 0.05).In conclusion, FRC and passive respiratory system compliance were significantly improved in preterm infants (25-34 weeks gestation) treated with a full course of antenatal steroids, compared to matched untreated infants. Although this study was not randomized, it confirms that antenatal steroids have important effects on pulmonary function that may contribute to a decreased risk of respiratory distress syndrome in treated preterm infants. (C) 2001 Wiley-Liss, Inc.