Mammel M C, Fisher J B, Bing D R, Gatto C W, Boros S J
Infant Pulmonary Research Center, Children's Hospital, St. Paul, Minnesota.
Pediatr Pulmonol. 1990;8(4):222-5. doi: 10.1002/ppul.1950080403.
We measured then compared the dynamic lung mechanics of spontaneous breaths and mechanical breaths in 9 mechanically ventilated neonates with hyaline membrane disease. All were receiving intermittent mandatory ventilation. All breathed spontaneously between ventilator breaths. Tidal volume, transpulmonary pressure, dynamic lung compliance, airways resistance, and peak inspiratory and peak expiratory gas flows were determined for both the mechanical and the spontaneous breaths. The mechanical breaths consistently had larger tidal volumes, higher transpulmonary pressures, higher airway resistance, and lower lung compliance values (P less than 0.05). Peak inspiratory and expiratory gas flows were also higher (P less than 0.01) during mechanical breathing. The spontaneous breaths generated by patients and the mechanical breaths generated by mechanical ventilators are different. The lung mechanics measurements of these two different types of breathing should be collected, analyzed, and reported separately.
我们对9例患有透明膜病的机械通气新生儿的自主呼吸和机械通气的动态肺力学进行了测量和比较。所有患儿均接受间歇强制通气。在呼吸机呼吸间隙，所有患儿均能自主呼吸。分别测定了机械通气和自主呼吸时的潮气量、跨肺压、动态肺顺应性、气道阻力以及吸气峰流速和呼气峰流速。机械通气时的潮气量始终更大、跨肺压更高、气道阻力更高且肺顺应性值更低（P<0.05）。机械通气时的吸气峰流速和呼气峰流速也更高（P<0.01）。患者产生的自主呼吸与机械通气产生的机械呼吸不同。这两种不同类型呼吸的肺力学测量结果应分别收集、分析和报告。
