Pulmonary function in preterm infants whose lungs were ventilated conventionally or by high-frequency oscillation.
Pulmonary function in preterm infants whose lungs were ventilated conventionally or by high-frequency oscillation.
复制标题
常规或高频振荡肺部通气的早产儿的肺功能。
DOI：
10.1016/s0022-3476(89)80346-4
复制
发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Bancalari,E
中科院分区：
文献类型：
--
作者：
Gerhardt,T;Reifenberg,L;Goldberg,RN;Bancalari,E
为了验证高频通气可以降低需要机械通气的早产儿的气压伤风险，从而降低慢性肺损伤的发生率的假设，我们对53名出生后第一天需要机械通气的婴儿在出院前进行了肺功能测定，并将其随机分为间歇性指令通气组（n=26）和高频振荡通气组（n= 26）。27）。两组新生儿体重无显著差异（平均值±SD：1010±240 vs 1030±230 gm），胎龄（29.1±2.0 vs 28.9±2.1周），初始辅助支持（平均气道压7.2±1.8 vs 8.1±2.1 cm H2O; Flo20.62±0.24 vs 0.75±0.22），机械通气持续时间间歇性指令通气组和高频振荡通气组的中位时间（范围）分别为6（1 - 61）vs 10（1 - 50）天）和氧疗持续时间（13（1 - 109）vs 27（4 - 227）天）。试验时，体重为1830±340 vs 1830±290 gm，年龄为68±24 vs 70±31天。呼吸流量通过呼吸速度描记术、通过充满水的饲管的食管压力和通过N2冲洗的功能性残气量来确定。两组均存在肺功能异常，肺顺应性降低（1.65±0.51 vs 1.54±0.36 ml/cm H2O）和肺阻力升高（102±24 vs 107±36 cm H2O/L/sec）。两组的功能性残气量均在正常范围内（30.6±6.0 vs 28.2±10.7 ml）。两个治疗组之间的肺功能无显著差异。这些结果不支持高频振荡通气降低早产儿肺损伤风险的假设。
To test the hypothesis that high-frequency ventilation may reduce the risk of barotrauma and thus the incidence of chronic pulmonary damage in preterm infants who need mechanical ventilation, we measured lung function before discharge in 53 infants who needed mechanical ventilation on the first day after birth and were randomly assigned to receive intermittent mandatory ventilation (n=26) or to receive high-frequency oscillatory ventilation (n=27). There were no significant differences between the groups in birth weight (mean ±SD: 1010±240 vs 1030±230 gm), gestational age (29.1±2.0 vs 28.9±2.1 weeks), initial ventilatory support (mean airway pressure 7.2±1.8 vs 8.1±2.1 cm H2O; Flo20.62±0.24 vs 0.75±0.22), duration of mechanical ventilation (median (range): 6 (1 to 61) vs 10 (1 to 50) days) and duration of oxygen therapy (13 (1 to 109) vs 27 (4 to 227) days) for the intermittent mandatory ventilation group and the high-frequency oscillatory ventilation group, respectively. At the time of testing, weight was 1830±340 vs 1830±290 gm, and age was 68±24 vs 70±31 days. Respiratory flows were determined by pneumotachygraphy, esophageal pressure through a water-filled feeding tube, and functional residual capacity by N2washout. Both groups had abnormal lung function with decreased lung compliance (1.65±0.51 vs 1.54±0.36 ml/cm H2O) and elevated pulmonary resistance (102±24 vs 107±36 cm H2O/L/sec). Functional residual capacity was in the normal range (30.6±6.0 vs 28.2±10.7 ml) in both groups. There were no significant differences in lung function between the two treatment groups. These results do not support the hypothesis that high-frequency oscillatory ventilation reduces the risk of lung damage in preterm infants.