Greenspan J S, Wolfson M R, Locke R G, Allen J L, Shaffer T H
Department of Pediatrics, Temple University School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania 19140.
Pediatr Res. 1992 Sep;32(3):356-9. doi: 10.1203/00006450-199209000-00022.
Ventilatory parameters and respiratory drive with and without an added acute resistive load were assessed in 11 healthy preterm infants and 11 infants with bronchopulmonary dysplasia (BPD). Lung mechanics (breathing frequency, tidal volume, minute ventilation, compliance, and resistance) were determined with esophageal manometry and pneumotachography. Respiratory drive was assessed by determining the airway pressure measured 100 ms after the onset of an inspiratory effort against an occlusion. Infants were studied at baseline and with an external inspiratory resistive load of 213.7 cm H2O/L/s. Infants with BPD had similar breathing frequency, tidal volume, and minute ventilation, lower compliance, and greater resistance and airway pressure at 100 ms than healthy preterm infants at rest. With loading, healthy preterm infants demonstrated increased airway pressure at 100 ms, whereas infants with BPD showed no change. Although the healthy preterm infants had decreased minute ventilation and tidal volume with loading, decreases in ventilation were greater in the infants with BPD. These data demonstrate that infants with BPD have responded to a chronic intrinsic load with increased drive. However, this may result in decreased ventilatory reserve and hence, a limited ability to adapt to acute pulmonary loads.
在11名健康早产儿和11名患有支气管肺发育不良（BPD）的婴儿中，评估了有无额外急性阻力负荷时的通气参数和呼吸驱动力。采用食管测压法和呼吸流速描记法测定肺力学指标（呼吸频率、潮气量、分钟通气量、顺应性和阻力）。通过测定吸气努力对抗阻塞开始后100毫秒时的气道压力来评估呼吸驱动力。在基线状态以及外部吸气阻力负荷为213.7厘米水柱/升/秒的情况下对婴儿进行研究。患有BPD的婴儿在静息状态下，与健康早产儿相比，呼吸频率、潮气量和分钟通气量相似，但顺应性较低，100毫秒时的阻力和气道压力较高。施加负荷时，健康早产儿在100毫秒时气道压力增加，而患有BPD的婴儿则无变化。尽管健康早产儿在施加负荷时分钟通气量和潮气量减少，但患有BPD的婴儿通气量减少幅度更大。这些数据表明，患有BPD的婴儿对慢性内在负荷的反应是驱动力增加。然而，这可能导致通气储备减少，因此适应急性肺部负荷的能力有限。
