McGill University Health Center, 2300 Tupper Street, Montreal, Québec, Canada, H3Z1L2.
Clin Perinatol. 2012 Sep;39(3):543-62. doi: 10.1016/j.clp.2012.06.003.
Protracted mechanical ventilation is associated with increased morbidity and mortality in preterm infants and thus the earliest possible weaning from mechanical ventilation is desirable. Weaning protocols may be helpful in achieving more rapid reduction in support. There is no clear consensus regarding the level of support at which an infant is ready for extubation. An improved ability to predict when a preterm infant has a high likelihood of successful extubation is highly desirable. In this article, available evidence is reviewed and reasonable evidence-based recommendations for expeditious weaning and extubation are provided.
长时间机械通气与早产儿发病率和死亡率增加相关,因此尽早脱离机械通气是理想的。撤机方案可能有助于更快地减少支持。对于婴儿在何种支持水平下准备好拔管,目前尚无明确共识。提高预测早产儿成功拔管可能性的能力是非常可取的。本文回顾了现有证据,并为迅速撤机和拔管提供了合理的基于证据的建议。