Fujino Y, Takezawa J, Nishimura M, Imanaka H, Taenaka N, Yoshiya I
Intensive Care Unit, Osaka University Hospital, Japan.
Crit Care Med. 1989 Apr;17(4):376-7. doi: 10.1097/00003246-198904000-00016.
A female neonate who had been diagnosed as having congenital diaphragmatic hernia by ultrasonography was delivered by cesarean section. After the hernia was repaired, she developed hypoxemia and hypercapnia, probably due to persistent fetal circulation (PFC). Neither conventional mechanical ventilation (CMV) nor manual ventilation improved the respiratory status. High-frequency oscillation (HFO) successfully improved pulmonary gas exchange, but we failed to wean the patient from HFO by using intermittent HFO. The patient was again placed on CMV for weaning and was extubated on the 12th ICU day. We conclude that HFO can be an alternative respiratory modality in patients with respiratory failure due to PFC after the repair of congenital diaphragmatic hernia.
一名经超声检查诊断为先天性膈疝的女新生儿通过剖宫产分娩。疝修补术后，她出现低氧血症和高碳酸血症，可能是由于持续性胎儿循环（PFC）所致。传统机械通气（CMV）和手动通气均未改善呼吸状况。高频振荡（HFO）成功改善了肺气体交换，但我们未能通过间歇性HFO使患者脱离HFO。患者再次接受CMV以进行撤机，并在重症监护病房（ICU）第12天拔管。我们得出结论，对于先天性膈疝修补术后因PFC导致呼吸衰竭的患者，HFO可以作为一种替代的呼吸模式。
