Gentile Michael A
Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Respir Care Clin N Am. 2006 Sep;12(3):489-500, ix. doi: 10.1016/j.rcc.2006.06.006.
The application of positive-pressure mechanical ventilation is one of the cornerstones of support for patients with acute respiratory failure. Unfortunately, the clinical condition of some patients does not improve, despite escalating ventilatory support. Adjunctive therapies to mechanical ventilation such as nitric oxide and heliox have been explored for the purposes of minimizing injurious settings and supporting adequate gas exchange. As specific therapies continue to evolve, clinicians should have a clear understanding of the physiologic basis and evidence before deciding to use any adjunctive therapy. This article discusses the role of nitric oxide and heliox as adjunct therapies to mechanical ventilation. Many questions remain about the role of these unique gases in the management of pediatric patients with acute respiratory failure. Should nitric oxide be used outside of its approved indication, and should heliox be used at all due to the lack of definitive evidence?
应用正压机械通气是支持急性呼吸衰竭患者的基石之一。不幸的是，尽管不断增加通气支持，一些患者的临床状况仍未改善。为了尽量减少有害设置并支持充分的气体交换，人们探索了一氧化氮和氦氧混合气等机械通气辅助疗法。随着特定疗法不断发展，临床医生在决定使用任何辅助疗法之前，应清楚了解其生理基础和证据。本文讨论一氧化氮和氦氧混合气作为机械通气辅助疗法的作用。关于这些独特气体在小儿急性呼吸衰竭管理中的作用，仍有许多问题。一氧化氮是否应在其批准适应症之外使用，以及由于缺乏确凿证据氦氧混合气是否应完全使用？
