ACQUIRED TRACHEOMEGALY IN VERY PRETERM NEONATES
ACQUIRED TRACHEOMEGALY IN VERY PRETERM NEONATES
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DOI：
10.1001/archpedi.1986.02140190059026
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发表时间：
1986-05-01
影响因子：
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通讯作者：
SHAFFER, TH
中科院分区：
文献类型：
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作者：
BHUTANI, VK;RITCHIE, WG;SHAFFER, TH
近端气道在妊娠早期是顺应性结构，并且在长期通气支持后可能容易受到压力引起的变形。16名新生儿（平均值±. SD胎龄，27.0 .+-。0.6周;平均值±。SD出生体重，847 . ±. 68 g），以评估气管体积变形。新生儿接受的辅助支持平均为±。SD持续时间为25.4 ±。4.9天在此期间，最大峰值吸气压力范围从15至25厘米水柱，和呼吸范围从20/分钟至60/分钟。这些新生儿在拔管后7天进行了研究，并分别与16个非通气新生儿的体重相匹配。在第一胸椎（T-1）和第三胸椎（T-3）的下缘测量气管气柱的宽度。通气组的平均气管宽度（T-1和T-3的平均值）明显（38%）更宽，平均. ±. SD气管宽度值为3.79 ±。0.29与对照组的2.74 ± 0.5mm相比，0.31根据这些数据，估计通气组的气管容积大91%。这些观察结果表明，接受机械通气支持的新生儿气管体积变形和获得性气管肥大。除了死腔通气增加外，这些发现还表明气管壁的潜在机械变形。
Proximal airways are compliant structures at early gestational ages and may be susceptible to pressure-induced deformation following prolonged ventilatory support. Sixteen neonates (mean .+-. SD gestational age, 27.0 .+-. 0.6 weeks; mean .+-. SD birth weight, 847 .+-. 68 g) were studied to assess tracheal volume deformation. The neonates received ventilatory support for a mean .+-. SD duration of 25.4 .+-. 4.9 days. During this period the maximum peak inspiratory pressures ranged from 15 to 25 cm H2O, and respirations ranged from 20/min to 60/min. These neonates were studied at seven days postextubation and were individually matched for body weight with 16 nonventilated neonates. The width of the tracheal air column was measured at the lower border of the first thoracic (T-1) and third thoracic (T-3) vertebrae. The average tracheal width (average of T-1 and T-3) was significantly (38%) wider in the ventilated group, and the mean .+-. SD tracheal width values were 3.79 .+-. 0.29 mm, as compared with the control values of 2.74 .+-. 0.31 mm. Based on these data it was estimated that the tracheal volume was 91% greater in the ventilated group. These observations demonstrate tracheal volume deformation and acquired tracheomegaly in neonates who have received mechanical ventilatory support. In addition to increased dead space ventilation, these findings also indicate underlying mechanical deformation of the tracheal wall.