Arca Marjorie J, Uhing Michael, Wakeham Martin
Division of Pediatric Surgery, Department of Surgery, Children׳s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Critical Care, Department of Pediatrics, Children׳s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin.
Division of Neonatology, Department of Pediatrics, Children׳s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin.
Semin Pediatr Surg. 2015 Feb;24(1):2-7. doi: 10.1053/j.sempedsurg.2014.11.001. Epub 2014 Nov 7.
Current trends in mechanical respiratory support are evolving toward gentle approaches to avoid short- and long-term problems that are historically associated with mechanical ventilation. These ventilator-associated issues include the need for long-term sedation, muscle deconditioning, ventilator-associated lung injury (VALI), and ventilator-associated pneumonia (VAP). This article will describe recent trends of ventilatory support in neonates and children: (1) utilization of volume ventilation in infants, (2) synchrony and improving patient-ventilator interaction specifically using neurally adjusted ventilatory assist (NAVA), and (3) use of noninvasive ventilation techniques. When applicable, their uses in the surgical newborn and pediatric patients are described.
机械呼吸支持的当前趋势正在朝着温和的方法发展，以避免长期以来与机械通气相关的短期和长期问题。这些与呼吸机相关的问题包括长期镇静的需求、肌肉失用、呼吸机相关性肺损伤（VALI）和呼吸机相关性肺炎（VAP）。本文将描述新生儿和儿童通气支持的最新趋势：（1）婴儿容量通气的应用，（2）同步性以及特别是使用神经调节通气辅助（NAVA）改善患者与呼吸机的相互作用，（3）无创通气技术的使用。在适用的情况下，还将描述它们在新生儿外科和儿科患者中的应用。
