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15-18 月龄矫正龄早产儿的肺容积和通气不均。

Lung volume and ventilation inhomogeneity in preterm infants at 15-18 months corrected age.

机构信息

School of Women's and Infant's Health, University of Western Australia, Perth, Australia.

出版信息

J Pediatr. 2010 Apr;156(4):542-9.e2. doi: 10.1016/j.jpeds.2009.10.017. Epub 2009 Dec 21.

Abstract

OBJECTIVE

To assess whether lung volume and ventilation inhomogeneity in preterm infants at 15-18 months corrected age, and the change in these outcomes from the newborn period to 15-18 months corrected age, depend on gestational age (GA) at birth and the severity of neonatal lung disease.

STUDY DESIGN

Preterm (GA range, 23-32 weeks) and term healthy control infants were studied in quiet sedated sleep at 15-18 months corrected age by multiple breath washout with 5% sulfur hexafluoride using an ultrasonic flowmeter. Valid measurements were obtained from 58 infants. Multivariate and multilevel regression was used to analyze outcomes.

RESULTS

Functional residual capacity (FRC), lung clearance index, and first and second to zeroeth moment ratios were calculated. After accounting for body size at test, FRC at follow-up, and the increase in FRC from the newborn period to 15-18 months corrected age were positively associated with GA and negatively associated with the duration of endotracheal ventilation. Indices of ventilation inhomogeneity were unaltered by GA and the duration of endotracheal ventilation.

CONCLUSIONS

In very preterm infants, GA and the duration of endotracheal ventilation are independently associated with reduced lung volume and lung growth during infancy, although the effect size of these findings is small.

摘要

目的

评估早产儿在 15-18 个月校正年龄时的肺容量和通气不均性,以及这些结果从新生儿期到 15-18 个月校正年龄的变化是否取决于出生时的胎龄(GA)和新生儿肺部疾病的严重程度。

研究设计

通过使用超声流量计的 5%六氟化硫多次呼吸冲洗,在早产儿(GA 范围为 23-32 周)和足月健康对照组婴儿在安静镇静睡眠中,在 15-18 个月校正年龄时进行研究。从 58 名婴儿中获得了有效的测量值。采用多元和多级回归分析结果。

结果

计算了功能残气量(FRC)、肺清除指数以及第一和第二零阶比。在考虑了测试时的身体大小、随访时的 FRC 以及从新生儿期到 15-18 个月校正年龄的 FRC 增加后,FRC 在随访时与 GA 呈正相关,与气管内通气的持续时间呈负相关。通气不均性指数与 GA 和气管内通气的持续时间无关。

结论

在极早产儿中,GA 和气管内通气的持续时间与婴儿期肺容量和肺生长减少独立相关,尽管这些发现的效应大小很小。

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