Gizzi Camilla, Moretti Corrado, Agostino Rocco
NICU-S. Giovanni Calibita Hospital Fatebenefratelli, Isola Tiberina-Rome, Italy.
J Matern Fetal Neonatal Med. 2011 Oct;24 Suppl 1:61-3. doi: 10.3109/14767058.2011.607683.
Mechanical ventilation is often required by very preterm infants with respiratory failure, even if invasive respiratory support is related to lung injury and adverse neurologic outcomes. The exposure to mechanical ventilation should be therefore limited. Optimal extubation however remains challenging, as approximately 30% of intubated preterm infants fails attempted extubation due to poor respiratory drive, atelectasis, residual pulmonary function abnormalities or intercurrent illness. This review outlines the advantages of different weaning strategies that should be considered by neonatologists for current use to reduce unsuccessful extubation.
患有呼吸衰竭的极早产儿常常需要机械通气,即便侵入性呼吸支持与肺损伤及不良神经学预后相关。因此,应限制机械通气的使用。然而,实现最佳拔管仍具有挑战性,因为约30%的插管早产儿因呼吸驱动不足、肺不张、残余肺功能异常或并发疾病而拔管尝试失败。本综述概述了不同撤机策略的优势,新生儿科医生在当前临床实践中应予以考虑,以减少拔管失败的发生。