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模拟新生儿呼吸对七种婴儿持续气道正压通气系统的比较。

Comparison of seven infant continuous positive airway pressure systems using simulated neonatal breathing.

机构信息

Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Pediatr Crit Care Med. 2012 Mar;13(2):e113-9. doi: 10.1097/PCC.0b013e31822f1b79.

Abstract

OBJECTIVE

Continuous positive airway pressure is an established treatment for respiratory distress in neonates. Continuous positive airway pressure has been applied to infants using an array of devices. The aim of this experimental study was to investigate the characteristics of seven continuous positive airway pressure systems using simulated breath profiles from newborns.

DESIGN

Experimental in vitro study.

SETTING

Research laboratory in Sweden.

INTERVENTION

None.

MEASUREMENTS AND MAIN RESULTS

In vitro simulation of spontaneous neonatal breathing was achieved with a mechanical lung model. Simulation included two breath profiles, three levels of continuous positive airway pressure with and without short binasal prongs and different levels of constant leak. Pressure stability and imposed work of breathing were determined. Seven continuous positive airway pressure systems were tested. There were large differences in pressure stability and imposed work of breathing between tested continuous positive airway pressure systems. Neopuff and Medijet had the highest pressure instability and imposed work of breathing. Benveniste, Hamilton Universal (Arabella), and Bubble continuous positive airway pressure showed intermediate results. AirLife and Infant Flow had the lowest pressure instability and imposed work of breathing. AirLife and Infant Flow showed the least decrease in delivered pressure when challenged with constant leak.

CONCLUSION

The seven tested continuous positive airway pressure systems showed large variations in pressure stability and imposed work of breathing. They also showed large differences in how well they maintain continuous positive airway pressure when exposed to leak. For most systems, imposed work of breathing increased with increasing continuous positive airway pressure level. The clinical importance of the difference in pressure stability is uncertain. Our results may facilitate the design of clinical studies examining the effect of pressure stability on outcome.

摘要

目的

持续气道正压通气是治疗新生儿呼吸窘迫的一种已确立的方法。持续气道正压通气已通过多种设备应用于婴儿。本实验研究的目的是使用新生儿模拟呼吸曲线来研究七种持续气道正压通气系统的特性。

设计

体外实验研究。

地点

瑞典的研究实验室。

干预

无。

测量和主要结果

使用机械肺模型实现了自发性新生儿呼吸的体外模拟。模拟包括两种呼吸曲线、有和无短鼻双侧鼻塞的三种不同水平的持续气道正压和不同水平的恒定泄漏。确定了压力稳定性和呼吸做功。测试了七种持续气道正压通气系统。测试的持续气道正压通气系统之间的压力稳定性和呼吸做功有很大差异。Neopuff 和 Medijet 的压力不稳定性和呼吸做功最大。Benveniste、Hamilton Universal(Arabella)和 Bubble 持续气道正压通气显示出中等结果。AirLife 和 Infant Flow 的压力不稳定性和呼吸做功最低。当受到恒定泄漏挑战时,AirLife 和 Infant Flow 显示出压力下降最小。

结论

七种测试的持续气道正压通气系统在压力稳定性和呼吸做功方面表现出很大的差异。它们在暴露于泄漏时保持持续气道正压的能力也存在很大差异。对于大多数系统,随着持续气道正压水平的增加,呼吸做功增加。压力稳定性差异的临床重要性尚不确定。我们的结果可能有助于设计研究压力稳定性对结果影响的临床研究。

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