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在胎粪吸入综合征动物模型中,气道灌洗并注入外源性表面活性剂后进行部分液体通气的随机对照研究。

A randomised control study of partial liquid ventilation after airway lavage with exogenous surfactant in a meconium aspiration syndrome animal model.

作者信息

Nakamura T, Matsuzawa S, Sugiura M, Tamura M

机构信息

Division of Neonatology, Nagano Children's Hospital, 3100 Toyoshina, Nagano, 399-8288 Japan.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2000 Mar;82(2):F160-2. doi: 10.1136/fn.82.2.f160.

DOI:10.1136/fn.82.2.f160
PMID:10685992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1721065/
Abstract

AIMS

To test the hypothesis that lavage with exogenous surfactant before partial liquid ventilation in meconium aspiration syndrome (MAS) would improve debris removal, and therefore the effectiveness of partial liquid ventilation.

METHODS

12 newborn piglets were randomised into 4 groups, partial liquid ventilation or gas ventilation, with and without surfactant lavage. Physiological and blood gas data were compared between groups by analysis of variance.

RESULTS

Arterial oxygen pressure (PaO(2)) was improved in the group treated with surfactant lavage when compared with the group not receiving surfactant. PaO(2) in the group receiving surfactant lavage followed by partial liquid ventilation was further improved when compared with the group treated with surfactant lavage followed by gas ventilation and the group receiving partial liquid ventilation alone.

CONCLUSION

The effectiveness of partial liquid ventilation in MAS might be enhanced by pretreatment with exogenous surfactant bronchial lavage.

摘要

目的

验证在胎粪吸入综合征(MAS)中,部分液体通气前用外源性表面活性剂灌洗能改善碎屑清除,从而提高部分液体通气效果的假说。

方法

12只新生仔猪随机分为4组,即部分液体通气组或气体通气组,每组又分为有和没有表面活性剂灌洗两个亚组。通过方差分析比较各组的生理和血气数据。

结果

与未接受表面活性剂治疗的组相比,接受表面活性剂灌洗治疗的组动脉血氧分压(PaO₂)有所改善。与接受表面活性剂灌洗后气体通气的组以及单独接受部分液体通气的组相比,接受表面活性剂灌洗后进行部分液体通气的组的PaO₂进一步提高。

结论

外源性表面活性剂支气管灌洗预处理可能会增强MAS中部分液体通气的效果。

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本文引用的文献

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Pediatr Res. 1998 Nov;44(5):705-15. doi: 10.1203/00006450-199811000-00013.
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Morphology and function of pulmonary surfactant inhibited by meconium.
Pediatr Res. 1998 Aug;44(2):187-91. doi: 10.1203/00006450-199808000-00008.
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Perfluorocarbon broncho-alveolar lavage and liquid ventilation versus saline broncho-alveolar lavage in adult guinea pig experimental model of meconium inhalation.在成年豚鼠胎粪吸入实验模型中,全氟化碳支气管肺泡灌洗和液体通气与盐水支气管肺泡灌洗的对比
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Surfactant replacement increases compliance in premature lamb lungs during partial liquid ventilation in situ.在原位部分液体通气期间,表面活性剂替代可增加早产羔羊肺的顺应性。
J Appl Physiol (1985). 1998 Apr;84(4):1316-22. doi: 10.1152/jappl.1998.84.4.1316.
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Exudative lung injury is associated with decreased levels of surfactant proteins in a rat model of meconium aspiration.在胎粪吸入大鼠模型中,渗出性肺损伤与表面活性蛋白水平降低有关。
Pediatrics. 1997 Dec;100(6):998-1003. doi: 10.1542/peds.100.6.998.
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Exogenous surfactant and partial liquid ventilation: physiologic and pathologic effects.外源性表面活性剂与部分液体通气:生理和病理效应
Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1058-65. doi: 10.1164/ajrccm.156.4.9610104.
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Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. The Inhaled Nitric Oxide Study Group.吸入一氧化氮与新生儿持续性肺动脉高压。吸入一氧化氮研究小组。
N Engl J Med. 1997 Feb 27;336(9):605-10. doi: 10.1056/NEJM199702273360902.
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Liquid assisted ventilation: an alternative ventilatory strategy for acute meconium aspiration injury.液体辅助通气:急性胎粪吸入性损伤的一种替代通气策略。
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Liquid ventilation: effects on pulmonary function in distressed meconium-stained lambs.
Pediatr Res. 1984 Jan;18(1):47-52.
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