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神经调节通气辅助在呼吸窘迫综合征早产儿中的应用

[Application of neurally adjusted ventilatory assist in preterm infants with respiratory distress syndrome].

作者信息

Chen Zheng, Luo Fang, Ma Xiao-Lu, Lin Hui-Jia, Shi Li-Ping, Du Li-Zhong

机构信息

Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2013 Sep;15(9):709-12.

Abstract

OBJECTIVE

To observe the effects of neurally adjusted ventilatory assist (NAVA) on the patient-ventilator synchrony, gas exchange, and ventilatory parameters in preterm infants with respiratory distress syndrome (RDS) during mechanical ventilation.

METHODS

Ten preterm infants with RDS received mechanical ventilation in NAVA mode for 60 minutes and in synchronized intermittent mandatory ventilation (SIMV) mode for 60 minutes, and the two modes were given in a random order. The vital signs, patient-ventilator synchrony, blood gas values, and ventilatory parameters were compared between the two ventilation modes.

RESULTS

Inspiratory trigger delay was significantly shorter with NAVA than with SIMV (P<0.05). There were no significant differences in arterial pH, PaCO2, PaO2 and PaO2/FiO2 between the two modes. The spontaneous respiratory rate, peak inspiratory pressure (PIP), electrical activity of the diaphragm and work of breathing were significantly lower in NAVA than in SIMV (P<0.05).

CONCLUSIONS

Compared with SIMV, NAVA appears to improve patient-ventilator synchrony, decrease PIP, and reduce diaphragmatic muscle load and work of breathing in preterm infants with RDS during mechanical ventilation.

摘要

目的

观察神经调节通气辅助(NAVA)对机械通气期间呼吸窘迫综合征(RDS)早产儿的患者 - 呼吸机同步性、气体交换及通气参数的影响。

方法

10例RDS早产儿分别接受NAVA模式机械通气60分钟和同步间歇指令通气(SIMV)模式机械通气60分钟,两种模式随机顺序给予。比较两种通气模式下的生命体征、患者 - 呼吸机同步性、血气值及通气参数。

结果

NAVA模式下吸气触发延迟显著短于SIMV模式(P<0.05)。两种模式下动脉血pH、PaCO2、PaO2及PaO2/FiO2无显著差异。NAVA模式下的自主呼吸频率、吸气峰压(PIP)、膈肌电活动及呼吸功显著低于SIMV模式(P<0.05)。

结论

与SIMV相比,NAVA似乎可改善RDS早产儿在机械通气期间的患者 - 呼吸机同步性,降低PIP,并减轻膈肌肌肉负荷及呼吸功。

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