[同步间歇指令通气对呼吸衰竭早产儿呼吸力学影响的临床研究]
[Clinical study on respiratory mechanics of synchronized intermittent mandatory ventilation in premature infants with respiratory failure].
作者信息
Wang Shao-hua, Yang Jun, Chen Shao-bo, Kuang Feng-wu
机构信息
NICU, Futian Women and Children Health Institute, Shenzhen 518045, Guangdong, China.
出版信息
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2004 Nov;16(11):670-2.
OBJECTIVE
To evaluate the clinical significance of synchronized intermittent mandatory ventilation (SIMV) in prematures infants necessitating assistant ventilation.
METHODS
Forty-two premature infants were studied in whom SIMV was used in 24 and intermittent mandatory ventilation (IMV) was used in 18. The parameters of fractional concentration of inspired oxygen (FiO(2)), peak inspiratory pressure (PIP), expiratory tidal volume (V(Texp)), oxygen index (OI), compliance of the respiratory system (Crs) and airway resistance (Raw) were compared. The frequency of administration of sedatives and incidence rate of complications were also compared between two groups.
RESULTS
In SIMV group, PIP, V(Texp), Raw and Crs were significant better after 2 hours ventilation (all P<0.05). There were significant difference in FiO(2) after 12 hours and OI at 24 hours in two groups. They were better in SIMV group. Sedatives were less used in SIMV group than IMV group (P<0.05).
CONCLUSION
In premature infants, SIMV could reduce FiO(2), PIP, OI, Raw and improve V(Texp), Crs more rapidly when assistant ventilation is necessary. The sedatives are used less in patients on SIMV.
目的
评估同步间歇指令通气（SIMV）在需要辅助通气的早产儿中的临床意义。
方法
对42例早产儿进行研究，其中24例使用SIMV，18例使用间歇指令通气（IMV）。比较两组患儿的吸入氧分数（FiO₂）、吸气峰压（PIP）、呼气潮气量（V（Texp））、氧合指数（OI）、呼吸系统顺应性（Crs）和气道阻力（Raw）等参数。同时比较两组患儿镇静剂的使用频率和并发症发生率。
结果
SIMV组通气2小时后，PIP、V（Texp）、Raw和Crs均明显改善（均P<0.05）。两组在通气12小时后的FiO₂和24小时时的OI存在显著差异，SIMV组更好。SIMV组镇静剂的使用少于IMV组（P<0.05）。
结论
对于早产儿，在需要辅助通气时，SIMV能更快降低FiO₂、PIP、OI、Raw，并改善V（Texp）、Crs。使用SIMV的患儿镇静剂使用更少。
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