Bancalari E, del Moral T
Division of Newborn Medicine, Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL 33101, USA.
J Perinatol. 2006 May;26 Suppl 1:S33-7; discussion S43-5. doi: 10.1038/sj.jp.7211471.
Mechanical ventilation is associated with significant short- and long-term morbidity in small preterm infants. Continuous positive airway pressure applied through nasal prongs is an effective, less-invasive method to improve gas exchange and reduce apnea in these infants. A large number of studies have evaluated the possibility of reducing the need or duration of mechanical ventilation by early use of nasal continuous positive airway pressure shortly after birth and by applying it after extubation. Although results of these trials have not been consistent, most of the evidence suggests that nasal continuous positive airway pressure is a viable alternative to mechanical ventilation in many preterm infants and that its use after extubation contributes to maintain better lung function and reduces apnea. Despite this, there is no evidence that these beneficial short-term effects translate into lower rates of long-term morbidity such as bronchopulmonary dysplasia and neurologic sequelae or mortality rates.
机械通气与小早产儿显著的短期和长期发病率相关。通过鼻导管施加持续气道正压通气是一种有效、侵入性较小的方法，可改善这些婴儿的气体交换并减少呼吸暂停。大量研究评估了在出生后不久尽早使用鼻持续气道正压通气以及在拔管后应用该方法来减少机械通气需求或持续时间的可能性。尽管这些试验的结果并不一致，但大多数证据表明，鼻持续气道正压通气在许多早产儿中是机械通气的可行替代方法，并且在拔管后使用有助于维持更好的肺功能并减少呼吸暂停。尽管如此，没有证据表明这些有益的短期效果能转化为较低的长期发病率，如支气管肺发育不良和神经后遗症发生率或死亡率。
