Lista G, Castoldi F, Cavigioli F, Bianchi S, Fontana P
Division of Neonatology, V Buzzi Children's Hospital, ICP, Milan, Italy.
J Matern Fetal Neonatal Med. 2012 Apr;25 Suppl 1:39-40. doi: 10.3109/14767058.2012.663164. Epub 2012 Mar 5.
Most preterm babies with a gestational age less than 23-27 weeks need a respiratory support in the delivery room (DR); the aim of ventilation is to create and maintain a functional residual capacity (FRC); to facilitate gas exchange and to minimize acute lung injury. The application of a continuous positive airway pressure (CPAP) from the first breaths helps in obtaining a lung volume stabilization. Efficacy and safety of the application of a sustained lung inflation (SLI) at birth is still under careful evaluation. The prompt increase of the hearth rate and oxygen saturation in the preliminary studies at the moment available in the literature are signs of the good efficacy of the manoeuvre but the effects of the SLI on oxygenation and hemodynamics are undetermined. When preterm infants need respiratory assistance in the DR, respiratory function monitoring is desirable to apply adequate and gentle resuscitation manoeuvres. Clinical large trials taking place in the DR are needed but they are also extremely difficult to be designed and performed.
大多数孕周小于23 - 27周的早产儿在产房需要呼吸支持；通气的目的是建立并维持功能残气量（FRC）；促进气体交换并使急性肺损伤最小化。从第一口呼吸开始应用持续气道正压通气（CPAP）有助于稳定肺容积。出生时应用肺持续膨胀（SLI）的有效性和安全性仍在仔细评估中。目前文献中的初步研究显示，心率和血氧饱和度迅速上升是该操作疗效良好的迹象，但SLI对氧合和血流动力学的影响尚未明确。当早产儿在产房需要呼吸辅助时，进行呼吸功能监测有助于实施充分且温和的复苏操作。需要在产房开展临床大型试验，但此类试验的设计和实施也极具难度。
