Sprague K, Graff G, Tobias D J
Department of Pediatrics, University of Missouri, Columbia 65212, USA.
South Med J. 2000 Oct;93(10):954-61.
Noninvasive positive-pressure ventilation (NIPPV) is increasingly used as an effective means of avoiding endotracheal intubation and mechanical ventilation in patients with respiratory insufficiency or failure.
We retrospectively reviewed our experience with NIPPV to treat respiratory failure in five patients with cystic fibrosis (CF).
Despite chronic lung disease related to CF, none of our cases were end-stage. All patients had recent pulmonary function tests showing a forced expiratory volume in 1 second (FEV1) of more than 30% predicted for age. All patients had progressive atelectasis, hypoxemia, and impending respiratory failure related to an acute pulmonary exacerbation or upper abdominal surgical procedure (open gastrostomy tube placement). Respiratory rates decreased, oxygen saturation increased, fraction of inspired oxygen (FiO2) requirement decreased, transcutaneous CO2 decreased, and atelectasis resolved with NIPPV.
Use of NIPPV provides effective respiratory support while avoiding the need for endotracheal intubation. The applications of NIPPV, reports of its use in patients with CF, and the equipment required are reviewed.
无创正压通气（NIPPV）越来越多地被用作避免呼吸功能不全或衰竭患者进行气管插管和机械通气的有效手段。
我们回顾性分析了应用NIPPV治疗5例囊性纤维化（CF）患者呼吸衰竭的经验。
尽管存在与CF相关的慢性肺部疾病，但我们的病例均未处于终末期。所有患者近期的肺功能检查显示，1秒用力呼气量（FEV1）超过年龄预测值的30%。所有患者均因急性肺部加重或上腹部外科手术（开放式胃造瘘管置入）出现进行性肺不张、低氧血症及即将发生的呼吸衰竭。使用NIPPV后，呼吸频率降低、氧饱和度升高、吸入氧分数（FiO2）需求降低、经皮二氧化碳分压降低，肺不张得到缓解。
使用NIPPV可提供有效的呼吸支持，同时避免气管插管的需要。本文对NIPPV的应用、其在CF患者中的使用报告以及所需设备进行了综述。
