Popow C, Simbruner G
Department of Paediatrics, University of Vienna.
Wien Klin Wochenschr. 1989 Apr 28;101(9):323-6.
We measured the compliance of the respiratory system (Crs) at 4 different tidal volumes (VT = 2.5, 5.0, 7.5, 10.0 ml/kg) in 29 mechanically ventilated newborn infants and determined the VT associated with the highest Crs ("optimal" VT) and with the lowest Crs ("worst" VT). Crs depended on the VT in all newborn infants investigated. The "optimal" VT most frequently observed was 2.5 and 5.0 ml/kg and the "worst" VT most frequently observed was 2.5 and 10.0 ml/kg. Mean Crs at the "optimal" VT was 62.3% higher than at the "worst" VT. The "optimal" VT was lower (2.5 ml/kg) in newborn infants with controlled ventilation than in newborn infants with intermittent mandatory ventilation (5.0 ml/kg). We conclude that it may be useful to determine the VT associated with the highest Crs in order to avoid unnecessarily high inflation pressures for the mechanical ventilation of newborn infants. Further studies are needed to assess long-term effects of such a Crs guided respirator therapy.
我们在29例机械通气的新生儿中，于4种不同潮气量（VT = 2.5、5.0、7.5、10.0 ml/kg）下测量了呼吸系统顺应性（Crs），并确定了与最高Crs相关的VT（“最佳”VT）和与最低Crs相关的VT（“最差”VT）。在所研究的所有新生儿中，Crs均取决于VT。最常观察到的“最佳”VT为2.5和5.0 ml/kg，最常观察到的“最差”VT为2.5和10.0 ml/kg。“最佳”VT时的平均Crs比“最差”VT时高62.3%。与间歇强制通气的新生儿（5.0 ml/kg）相比，控制通气的新生儿的“最佳”VT更低（2.5 ml/kg）。我们得出结论，确定与最高Crs相关的VT可能有助于避免在新生儿机械通气时使用不必要的高充气压力。需要进一步研究来评估这种Crs指导的呼吸治疗的长期效果。
