Bhutani Vinod K
Section on Newborn Pediatrics, Pennsylvania Hospital, University of Pennsylvania School of Medicine, 800 Spruce Street, Philadelphia, PA 19107, USA.
Semin Neonatol. 2002 Oct;7(5):391-9. doi: 10.1053/siny.2002.0133.
Pulmonary function and mechanics testing are emerging as a valuable tool to aid clinical decision making in the management of ventilated infants. Although there are as yet no published randomized controlled trials to suggest that pulmonary mechanics testing reduces mortality or morbidity, it has--in conjunction with clinical, radiological, and blood gas monitoring--changed neonatal ventilation from "good judgement" to "informed judgement". It is not surprising that pulmonary graphics are increasingly being used as a tool for assessment of patient status, therapeutic evaluation, and management guidance of infants who become dependent on ventilator. A working knowledge of pulmonary graphics also improves understanding of pulmonary physiology and pathophysiology, and their responses to mechanical ventilatory support. Recent advances in microprocessor technology for on-line analysis of pulmonary mechanics have made such evaluations easily available for bedside clinical application.
肺功能和力学测试正逐渐成为辅助机械通气婴儿临床决策的一项重要工具。尽管目前尚无已发表的随机对照试验表明肺力学测试能降低死亡率或发病率,但它与临床、放射学及血气监测相结合,已使新生儿通气从“经验判断”转变为“基于信息的判断”。肺功能图越来越多地被用作评估依赖呼吸机婴儿的病情状况、治疗效果及管理指导的工具,这并不奇怪。对肺功能图的实用知识了解也有助于增进对肺生理和病理生理及其对机械通气支持反应的理解。微处理器技术在肺力学在线分析方面的最新进展,已使此类评估易于应用于床边临床实践。