Siles Quesada C, Puyol Buil P, Omeñaca Teres F, Molero Díaz F, Díaz Cirujano A, González Montero R, de Castro Fernández J, Belaustegui Cueto A
Servicio de Neonatología, Hospital 12 de Octubre, Madrid.
An Esp Pediatr. 1992 Nov;37(5):361-5.
The clinical histories of 27 neonates ventilated with high frequency respirators (Volumetric Diffusive Respirator VDR-2) have been analyzed in order to evaluate the efficiency of this type of ventilation in neonatal pathology. The average gestational age of these patients was 32 +/- 4 weeks. Most of them (70%) presented respiratory distress due to hyaline membrane disease. Of the remaining cases, three (11%) presented with congenital diaphragmatic hernia, two with pulmonary hypertension, two with meconium aspiration syndrome, one with Group B Streptococal sepsis/shock and one with case diaphragmatic agenesia. Between two and six hours after initiation of high frequency ventilation (HFV), pH, paCO2 and pO2 improved significantly in relationship to former values (p < 0.05- p < 0.001), reaching values in the normal range at 6.5 +/- 14 hours regarding pH, 30 +/- 50 hours regarding paCO2 and 6.5 +/- 10 hours regarding paO2. No hemodynamic modification could be attributed to this procedure. The principal complications were ectopic air (62%) and necrotizing tracheobronchitis (TBN) (25%). Bronchopulmonary dysplasia (BDP) was diagnosed in 20% of the cases, ductus (DAP) in 33% of the cases and intracraneal hemorrhage in 25% of the cases. Mortality was 70%. High frequency ventilation is an alternative procedure to conventional ventilation in this group of neonates. It produces an important number of favorable responses, but has complications that can not be overlooked.
为评估高频呼吸机（容积扩散呼吸机VDR - 2）在新生儿疾病中的通气效率，分析了27例使用该类呼吸机通气的新生儿的临床病史。这些患者的平均胎龄为32±4周。其中大多数（70%）因肺透明膜病出现呼吸窘迫。其余病例中，3例（11%）患有先天性膈疝，2例患有肺动脉高压，2例患有胎粪吸入综合征，1例患有B组链球菌败血症/休克，1例患有先天性膈发育不全。在开始高频通气（HFV）后两到六小时内，pH值、动脉血二氧化碳分压（paCO2）和动脉血氧分压（pO2）与之前的值相比有显著改善（p < 0.05 - p < 0.001），pH值在6.5±14小时达到正常范围，paCO2在30±50小时达到正常范围，pO2在6.5±10小时达到正常范围。该操作未引起血流动力学改变。主要并发症为异位气体（62%）和坏死性气管支气管炎（TBN）（25%）。20%的病例诊断为支气管肺发育不良（BDP），33%的病例诊断为动脉导管未闭（DAP），25%的病例诊断为颅内出血。死亡率为70%。高频通气是这组新生儿传统通气的替代方法。它产生了许多有利反应，但也有一些不容忽视的并发症。
