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[牛肺表面活性物质对极低出生体重先天性肺炎早产儿的影响]

[Effect of a bovine surfactant in very low birth weight premature infants with congenital pneumonia].

作者信息

Gortner L, Pohlandt F, Bartmann P

机构信息

Gemeinsame Einrichtung Neonatologie und Pädiatrische Intensivmedizin, Universitäts-Kinderklinik Ulm.

出版信息

Monatsschr Kinderheilkd. 1990 May;138(5):274-8.

PMID:2377170
Abstract

15 VLBW-infants, who were classified to suffer from congenital pneumonia, were treated with a bovine surfactant. Mean gestational age was 25.5 weeks (range 23-27 weeks), mean birth weight was 700 g (range 530-930 g). Surfactant was instilled intratracheally at a mean dose of 41 mg/kg body weight (b.w.) (range 30-50 mg) 8 h after birth (range 6-12 h), if the fraction of inspired oxygen (FiO2) was greater than 0.5 or the peak inspiratory pressure (PIP) was greater than 22 cm H2O (b.w. less than 750 g) or greater than 25 cm H2O (b.w. 751-1000 g). Retreatment up to a total maximum of 4 doses of surfactant was permitted. Surfactant treatment reduced FiO2 from a pretreatment value of 0.79 to 0.50 one hour after application, however, 12 h later FiO2 had increased again to 0.75. Ventilation pressures showed a slight decrease during 12 h after surfactant treatment. 6 infants received 1 dose, multiple doses were given to 9 infants. 5 infants survived, 4 infants died from respiratory failure, 4 from sepsis and 2 from severe intracranial haemorrhage.

摘要

15名被诊断患有先天性肺炎的极低出生体重儿接受了牛肺表面活性物质治疗。平均胎龄为25.5周(范围23 - 27周),平均出生体重为700克(范围530 - 930克)。若出生后6 - 12小时内吸入氧分数(FiO₂)大于0.5,或出生体重低于750克时峰值吸气压力(PIP)大于22厘米水柱,或出生体重751 - 1000克时PIP大于25厘米水柱,则在出生后8小时(范围6 - 12小时)经气管内滴注肺表面活性物质,平均剂量为41毫克/千克体重(范围30 - 50毫克)。允许再次治疗,最多总共使用4剂肺表面活性物质。肺表面活性物质治疗后1小时,FiO₂从治疗前的0.79降至0.50,但12小时后FiO₂又升至0.75。肺表面活性物质治疗后12小时内通气压力略有下降。6名婴儿接受了1剂治疗,9名婴儿接受了多剂治疗。5名婴儿存活,4名婴儿死于呼吸衰竭,4名死于败血症,2名死于严重颅内出血。

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