Hückstädt Thomas, Foitzik Bertram, Wauer Roland R, Schmalisch Gerd
Clinic of Neonatology CCM, Humboldt-University, Medical School (Charité), Schumannstrasse 20/21, 10098, Berlin, Germany.
Intensive Care Med. 2003 Jul;29(7):1134-40. doi: 10.1007/s00134-003-1785-0. Epub 2003 May 27.
Comparison of tidal breathing and pressure fluctuation of the continuous positive airway pressure (CPAP) associated with the use of the valveless Infant Flow System versus the conventional constant-flow CPAP (Babylog 8000) in preterm infants.
Randomized cross-over trial.
Neonatal intensive care unit level III.
Twenty infants; median (range): birth weight 1,035 g (640-4,110 g), actual weight 1,165 g (820-4,250 g), gestational age at birth 27 (26-40) weeks.
After extubation two CPAP devices (Infant Flow System vs Babylog 8000) were applied in a random order to the same infant. Fluctuations of the applied pressure during the breathing cycle and tidal breathing parameters were measured by the flow-through technique.
Using the Infant Flow System the mean (standard deviation) inspiratory flow [1.5 (0.1) vs 1.3 (0.1) l.min(-1).kg(-1), P<0.05] and tidal volume were significantly increased [5.3 (1.3) vs 4.7 (1.3) ml/kg(-1), P<0.05] compared to Babylog 8000. The fluctuations of the applied pressure of the Infant Flow System during the breathing cycle were significantly lower [0.1 (0.03) kPa vs 0.15 (0.08) kPa, P<0.05] compared to Babylog 8000. No differences were seen in the duration of inspiration and expiration and the time to peak tidal flow. In the Infant Flow System pressures during expiration remained stable whereas they increased during the use of Babylog 8000.
Within-subject comparisons of tidal breathing parameters of the two CPAP devices Infant Flow System and Babylog 8000 show: (1) a significant influence of the system used; and (2) that the valveless Infant Flow System increases air flow and tidal volume with less fluctuations in CPAP pressures during the breathing cycle.
比较无阀婴儿气流系统与传统恒流持续气道正压通气（CPAP）（Babylog 8000）在早产儿中应用时的潮气呼吸及CPAP压力波动情况。
随机交叉试验。
三级新生儿重症监护病房。
20例婴儿；中位数（范围）：出生体重1035克（640 - 4110克），实际体重1165克（820 - 4250克），出生胎龄27（26 - 40）周。
拔管后，将两种CPAP设备（婴儿气流系统与Babylog 8000）以随机顺序应用于同一婴儿。通过流通技术测量呼吸周期中施加压力的波动及潮气呼吸参数。
与Babylog 8000相比，使用婴儿气流系统时，平均（标准差）吸气流量显著增加[1.5（0.1）对1.3（0.1）升·分钟⁻¹·千克⁻¹，P < 0.05]，潮气量也显著增加[5.3（1.3）对4.7（1.3）毫升/千克⁻¹，P < 0.05]。与Babylog 8000相比，婴儿气流系统在呼吸周期中施加压力的波动显著更低[0.1（0.03）千帕对0.15（0.08）千帕，P < 0.05]。吸气和呼气持续时间以及潮气流速峰值时间未见差异。在婴儿气流系统中，呼气时压力保持稳定，而使用Babylog 8000时压力会升高。
对两种CPAP设备（婴儿气流系统和Babylog 8000）的潮气呼吸参数进行的受试者内比较显示：（1）所用系统有显著影响；（2）无阀婴儿气流系统可增加气流和潮气量，且在呼吸周期中CPAP压力波动较小。
