Burgess G H, Oh W, Brann B S, Brubakk A M, Stonestreet B S
Department of Pediatrics, Brown University School of Medicine, Women and Infants Hospital of Rhode Island, 101 Dudley St, Providence, RI 02905-240, USA.
Arch Pediatr Adolesc Med. 2001 Jun;155(6):723-7. doi: 10.1001/archpedi.155.6.723.
To examine the effect of phenobarbital administration on anterior cerebral artery blood flow velocity before and after endotracheal suctioning in premature neonates.
Transcutaneous PO(2) (TcPO(2)), heart rate, mean arterial blood pressure (MABP), and Doppler velocimeter blood flow of the left anterior cerebral artery were measured before and immediately after 3 consecutive endotracheal suctioning procedures in premature neonates. Intravenous phenobarbital (20 mg/kg) was administered immediately after the first procedure.
Neonatal intensive care unit.
Nine neonates with a mean birth weight of 807 g (range, 620-1060 g) and a mean gestational age of 27 weeks (range, 25-30 weeks) were studied at age 8 to 12 hours.
Transcutaneous PO(2) decreased in response to endotracheal suctioning at each of the suctioning procedures before and after phenobarbital was given (P<.001). Changes in heart rate were not observed. There were increases in MABP and area under the velocity curve (AUVC) per minute in response to endotracheal suctioning before but not after phenobarbital administration (P=.046). Use of phenobarbital lowered the overall peak systolic blood flow velocity in response to endotracheal suctioning (P =.02, analysis of variance, interactions for the effect of phenobarbital therapy on the response to suctioning). Changes in end-diastolic blood flow velocity were not observed. There were decreases in the differences before and after endotracheal suctioning for MABP at 2 and 4 hours and for AUVC and peak systolic blood flow velocity 4 hours after phenobarbital was given (P =.04).
In very low-birth-weight neonates, endotracheal suctioning is associated with decreases in TcPO(2) and increases in MABP and AUVC. Treatment with phenobarbital attenuates the increases in MABP and AUVC but not the decreases in TcPO(2) after endotracheal suctioning.
探讨苯巴比妥给药对早产儿气管内吸引前后大脑前动脉血流速度的影响。
在早产儿连续进行3次气管内吸引操作前及操作后即刻，测量经皮血氧分压（TcPO₂）、心率、平均动脉血压（MABP）以及左大脑前动脉的多普勒血流速度。在首次操作后即刻静脉注射苯巴比妥（20mg/kg）。
新生儿重症监护病房。
9例新生儿，平均出生体重807g（范围620 - 1060g），平均胎龄27周（范围25 - 30周），于出生8至12小时进行研究。
在给予苯巴比妥前后的每次吸引操作中，气管内吸引均导致经皮血氧分压下降（P<0.001）。未观察到心率变化。在给予苯巴比妥前，气管内吸引导致MABP及每分钟速度曲线下面积（AUVC）增加，但给予苯巴比妥后未出现此情况（P = 0.046）。使用苯巴比妥可降低气管内吸引引起的总体收缩期峰值血流速度（P = 0.02，方差分析，苯巴比妥治疗对吸引反应影响的交互作用）。未观察到舒张末期血流速度变化。在给予苯巴比妥后2小时和4小时，气管内吸引前后MABP的差值以及4小时时AUVC和收缩期峰值血流速度的差值均减小（P = 0.04）。
在极低出生体重儿中，气管内吸引与经皮血氧分压降低、MABP及AUVC增加相关。苯巴比妥治疗可减轻气管内吸引后MABP及AUVC的增加，但不能减轻经皮血氧分压的降低。
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