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全身深度低温期间肺功能是否发生变化?

Does pulmonary function change during whole-body deep hypothermia?

机构信息

Neonatal Intensive Care Unit, Fondazione IRCCS Cà' Granda-Ospedale Maggiore Policlinico, University Department of Mother and Infant Sciences, University of Milan, Milan, Italy.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2011 Sep;96(5):F374-7. doi: 10.1136/adc.2009.181826. Epub 2010 Jun 7.

Abstract

Whole-body deep hypothermia (DH) could be a new therapeutic strategy for asphyxiated newborn. Aim of this study was to describe how DH (core temperature 30-33°C) modifies the respiratory function if compared with mild hypothermia (MH; core temperature 33-34°C). This is an observational study. Results were obtained from a pilot study of safety of DH and topiramate in neonatal hypoxic-ischaemic encephalopathy. Fifty-seven newborns were enrolled: 29 patients in DH and 28 in MH. Recruitment criteria were moderate-severe hypoxic-ischaemic encephalopathy and gestational age ≥36 weeks. Mechanical ventilation was set to maintain SaO(2) between 92% and 95%. Nineteen patients in DH and 18 in MH required mechanical ventilation. Of these patients, 10 and 12, respectively, did not required oxygen. No significant differences were observed in hours of oxygen and ventilation support, respiratory rate and PaCO(2). Maximum FiO(2), peak inspiratory pressure, positive end-expiratory pressure, minute ventilation and tidal volume during hypothermia were similar. Pulmonary function with different levels of hypothermia was similar.

摘要

全身深低温(DH)可能成为窒息新生儿的一种新的治疗策略。本研究旨在描述与亚低温(MH;核心温度 33-34°C)相比,DH(核心温度 30-33°C)如何改变呼吸功能。这是一项观察性研究。结果来自于 DH 和托吡酯治疗新生儿缺氧缺血性脑病的安全性的初步研究。共纳入 57 例新生儿:29 例患者进行 DH,28 例患者进行 MH。入选标准为中重度缺氧缺血性脑病和胎龄≥36 周。机械通气设置为维持 SaO₂在 92%至 95%之间。19 例 DH 患者和 18 例 MH 患者需要机械通气。其中,分别有 10 例和 12 例患者不需要吸氧。在吸氧和通气支持时间、呼吸频率和 PaCO₂方面无显著差异。低温期间最大 FiO₂、吸气峰压、呼气末正压、分钟通气量和潮气量相似。不同程度低温时的肺功能相似。

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