Coates E W, Klinepeter M E, O'Shea T M
1Department of Pediatrics, Wake Forest University School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
J Perinatol. 2008 Oct;28(10):675-9. doi: 10.1038/jp.2008.76. Epub 2008 Jun 26.
Term and near-term infants with pulmonary hypertension are frequently treated with inhaled nitric oxide. This therapy can be delivered with high-frequency ventilation, but there has been limited study of the relative effectiveness of high-frequency jet ventilation and high-frequency oscillatory ventilation.
To compare short-term clinical outcomes of neonates with pulmonary hypertension treated with inhaled nitric oxide plus either high-frequency jet ventilation or high-frequency oscillatory ventilation.
Study infants met the following criteria: >or=35 weeks gestation, respiratory failure with pulmonary hypertension, no congenital malformations and treatment in the first week of life with inhaled nitric oxide plus either high-frequency jet ventilation (n=22) or high-frequency oscillatory ventilation (n=43). Data were collected from medical records.
The jet ventilation and oscillatory ventilation groups were similar in terms of gestational age, but the jet ventilation group had less severe respiratory illness (that is, lower oxygenation index) just prior to initiation of the combination of nitric oxide and high-frequency ventilation. The jet ventilation group spent more hours on inhaled nitric oxide (71.4 versus 40.8; P=0.004) but was less likely to require extracorporeal membrane oxygenation (2(9%) versus 19(44%); P=0.004). No difference was found in the ages at which oxygen and high-frequency ventilation were discontinued.
Term and near-term neonates with pulmonary hypertension who require nitric oxide have similar short-term outcomes regardless of whether nitric oxide is delivered by high-frequency jet ventilation or high-frequency oscillatory ventilation.
患有肺动脉高压的足月儿和近足月儿常接受吸入一氧化氮治疗。这种治疗可通过高频通气进行，但关于高频喷射通气和高频振荡通气的相对有效性的研究有限。
比较接受吸入一氧化氮加高频喷射通气或高频振荡通气治疗的肺动脉高压新生儿的短期临床结局。
研究婴儿符合以下标准：妊娠≥35周，伴有肺动脉高压的呼吸衰竭，无先天性畸形，且在出生后第一周接受吸入一氧化氮加高频喷射通气（n = 22）或高频振荡通气（n = 43）治疗。数据从病历中收集。
喷射通气组和振荡通气组在胎龄方面相似，但在开始一氧化氮与高频通气联合治疗前，喷射通气组的呼吸系统疾病较轻（即氧合指数较低）。喷射通气组吸入一氧化氮的时间更长（71.4小时对40.8小时；P = 0.004），但需要体外膜肺氧合的可能性较小（2例（9%）对19例（44%）；P = 0.004）。在停止吸氧和高频通气的年龄方面未发现差异。
需要一氧化氮治疗的患有肺动脉高压的足月儿和近足月儿，无论一氧化氮是通过高频喷射通气还是高频振荡通气给药，其短期结局相似。
