Davis Peter G, Morley Colin J, Owen Louise S
Department of Neonatal Services, The Royal Women's Hospital, Parkville, VIC 3052, Australia.
Semin Fetal Neonatal Med. 2009 Feb;14(1):14-20. doi: 10.1016/j.siny.2008.08.003. Epub 2008 Oct 4.
Non-invasive techniques of respiratory support were developed in order to reduce the adverse effects associated with ventilation via an endotracheal tube. Short bi-nasal prongs provide the most effective nasal interface for delivery of nasal continuous positive airway pressure (nCPAP). Devices used to generate CPAP include conventional ventilators, the 'bubbly bottle' system and the infant flow driver. NCPAP improves the rate of successful extubation. It is useful for preterm infants with respiratory distress syndrome, reducing time spent on an endotracheal tube and oxygen requirement at 28d. However, nCPAP is associated with an increased rate of pneumothorax. Nasal intermittent positive pressure ventilation (NIPPV) is useful for augmenting the effectiveness of nCPAP. It further improves rates of successful extubation and shows promise as an initial method of respiratory support. Further research is required to determine the optimal settings for both nCPAP and NIPPV.
为了减少与经气管插管通气相关的不良影响，人们开发了无创呼吸支持技术。短双侧鼻导管是用于输送经鼻持续气道正压通气（nCPAP）的最有效鼻接口。用于产生CPAP的设备包括传统呼吸机、“气泡瓶”系统和婴儿气流驱动装置。NCPAP提高了成功拔管率。它对患有呼吸窘迫综合征的早产儿有用，可减少28天时在气管插管上花费的时间和氧气需求。然而，nCPAP与气胸发生率增加有关。经鼻间歇正压通气（NIPPV）有助于提高nCPAP的有效性。它进一步提高了成功拔管率，并有望作为一种初始呼吸支持方法。需要进一步研究以确定nCPAP和NIPPV的最佳设置。
