Carlo W A, Beoglos A, Chatburn R L, Walsh M C, Martin R J
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106.
Am J Dis Child. 1989 Feb;143(2):233-8. doi: 10.1001/archpedi.1989.02150140127034.
To determine if high-frequency jet ventilation is beneficial in neonates with persistent pulmonary hypertension, we compared the ventilator settings, blood gas concentrations, and outcome of infants who met established criteria for a high predictive mortality. During a six-year period, 14 neonates who had severe respiratory failure and hypoxemia while receiving conventional ventilation were treated with high-frequency jet ventilation. Twenty-three comparable infants meeting the same criteria were treated exclusively with conventional ventilation. After initiation of high-frequency jet ventilation there was a significant reduction in mean airway pressure and partial pressure of arterial carbon dioxide (PaCO2). In contrast, neonates treated exclusively with conventional ventilation continued to have higher airway pressures and PaCO2. However, there was no difference in the alveolar-to-arterial oxygen gradient, air leakage, incidence of bronchopulmonary dysplasia, or duration of assisted ventilation or oxygen supplementation. Furthermore, mortality was comparable in both groups of infants. These preliminary observations suggest that high-frequency jet ventilation can reduce airway pressure and PaCO2 in neonates with persistent pulmonary hypertension but does not appear to improve outcome.
为了确定高频喷射通气对患有持续性肺动脉高压的新生儿是否有益，我们比较了符合高预测死亡率既定标准的婴儿的呼吸机设置、血气浓度和预后情况。在六年期间，14例在接受传统通气时出现严重呼吸衰竭和低氧血症的新生儿接受了高频喷射通气治疗。另外23例符合相同标准的类似婴儿仅接受了传统通气治疗。开始高频喷射通气后，平均气道压力和动脉血二氧化碳分压（PaCO2）显著降低。相比之下，仅接受传统通气治疗的新生儿气道压力和PaCO2持续较高。然而，两组婴儿在肺泡-动脉氧梯度、气漏、支气管肺发育不良的发生率、辅助通气或吸氧持续时间方面并无差异。此外，两组婴儿的死亡率相当。这些初步观察结果表明，高频喷射通气可降低患有持续性肺动脉高压的新生儿的气道压力和PaCO2，但似乎并未改善预后。
