对增加无效腔及体位的通气反应在高危年龄的早产婴儿中与婴儿猝死综合征的关系。（注：原英文标题表述不太完整准确，这样翻译是根据字面意思尽量贴近原意，完整准确的理解可能需要结合更多的研究背景知识，比如这里的“高危年龄”具体所指等）若严格按照字面翻译为：对高危年龄的早产婴儿中增加无效腔及体位的通气反应感觉不太能清晰表达出其完整含义，供你参考。准确来说，这个标题可能想表达的是关于早产婴儿在处于婴儿猝死综合征高危年龄时，其对增加无效腔和不同体位的通气反应相关研究内容。最终呈现译文：在婴儿猝死综合征高危年龄的早产婴儿中，增加无效腔及体位对通气反应的影响（这样表述更符合常见医学研究标题的表意习惯）你可根据实际需求选择合适译文。正式答题：在婴儿猝死综合征高危年龄的早产婴儿中，增加无效腔及体位对通气反应的影响（再次强调，这是在充分理解标题意图后优化的译文，若仅按字面严格翻译就是前面给出的不太能清晰表意的版本）最终正式答案：在婴儿猝死综合征高危年龄的早产婴儿中，增加无效腔及体位对通气反应的影响（此为最能准确表意的译文）以上是对整个翻译思路及优化过程的详细说明，正式答案：在婴儿猝死综合征高危年龄的早产婴儿中，增加无效腔及体位对通气反应的影响

Ventilatory response to added dead space and position in preterm infants at high risk age for SIDS.

作者信息

Saiki Tolulope, Hannam Simon, Rafferty Gerrard F, Milner Anthony D, Greenough Anne

机构信息

Division of Asthma, Allergy and Lung Biology, MRC-Asthma Centre, King's College London, London, United Kingdom.

出版信息

Pediatr Pulmonol. 2011 Mar;46(3):239-45. doi: 10.1002/ppul.21358. Epub 2010 Oct 26.

DOI:10.1002/ppul.21358

PMID:24081885

Abstract

OBJECTIVE

The vulnerability of prematurely born infants to sudden infant death syndrome (SIDS) in the prone position might be explained by a reduced ability to respond to a stress, such as hypercarbia, in that position; our objective, therefore, was to further explore the influence of position on the response to a stress.

WORKING HYPOTHESIS

The ability of prematurely born infants to respond to added dead space in the prone compared to the supine position would be impaired at the high risk age for SIDS.

PATIENTS

Twenty infants, median gestational age of 30 (range 24-32) weeks were studied at a median postmenstrual age (PMA) of 45 weeks. In addition, comparisons were made to the results of 25 infants studied at 36 weeks PMA.

METHODOLOGY

Infants were studied supine and prone. Breath by breath minute volume was measured at baseline and after a dead space was incorporated into the breathing circuit; the time constant of the response was calculated. The pressure generated in the first 100 msec of an occlusion (P0.1 ), the maximum inspiratory pressure during an airway occlusion and functional residual capacity (FRC) were also measured in both positions.

RESULTS

The median time constant was longer (38 (range 15-85) vs. 26 (range 2-40) sec (P = 0.002)). P0.1 lower (P = 0.003) and FRC higher (P = 0.031) in the prone compared to the supine position. In the prone position, the time constant correlated with PMA (P = 0.047), that is, the rate of response to added dead space was significantly damped with increasing postnatal age up to the critical age for SIDS.

CONCLUSIONS

The dampened rate of response to added dead space in the prone compared to the supine position lends support to the hypothesis that a poorer response to a stress may contribute to prematurely born infants increased risk of SIDS in the prone position.

摘要

目的

早产婴儿在俯卧位时易患婴儿猝死综合征（SIDS），这可能是由于其在该体位下对诸如高碳酸血症等应激反应的能力下降所致；因此，我们的目的是进一步探讨体位对应激反应的影响。

工作假说

在SIDS的高危年龄，早产婴儿在俯卧位时对增加无效腔的反应能力相较于仰卧位会受损。

患者

研究了20名婴儿，其孕周中位数为30（范围24 - 32）周，月经龄（PMA）中位数为45周。此外，将结果与25名在PMA 36周时进行研究的婴儿的结果进行了比较。

方法

对婴儿进行仰卧位和俯卧位研究。在基线时以及在呼吸回路中加入无效腔后，逐次呼吸测量每分通气量；计算反应的时间常数。还在两个体位下测量了阻塞开始后100毫秒内产生的压力（P0.1）、气道阻塞期间的最大吸气压力和功能残气量（FRC）。

结果

时间常数中位数更长（38（范围15 - 85）秒 vs. 26（范围2 - 40）秒，P = 0.002）。与仰卧位相比，俯卧位时P0.1更低（P = 0.003），FRC更高（P = 0.031）。在俯卧位时，时间常数与PMA相关（P = 0.047），即对增加无效腔的反应速率随着出生后年龄增加直至SIDS的临界年龄而显著衰减。