Sánchez-Luna M, González-Pacheco N, Belik J, Santos M, Tendillo F
Division of Neonatology, Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University of Madrid, Hospital General Universitario "Gregorio Marañón," Madrid, Spain.
Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Am J Perinatol. 2018 May;35(6):545-548. doi: 10.1055/s-0038-1637763. Epub 2018 Apr 25.
High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV-volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Different I:E ratios also can modify the effect of CO washout during HFOV combined with VG in a different way as without the VG modality. Finally, clinical use of this technique in newborn infants has demonstrated the possibility of using very high frequency combined with constant very low VThf to decrease the risk of lung trauma related to the ventilator.
高频振荡通气（HFOV）已被提议作为未成熟婴儿有创通气的替代方法，以预防呼吸机肺损伤。为了更好地控制高频潮气量的大小并防止大潮气量，已开发出一种在高频振荡通气期间控制潮气量（VThf）的新策略，即高频振荡通气容量保证（VG）。来自正常和表面活性物质缺乏肺的临床前新生儿动物研究数据表明，该技术在正常顺应性和低顺应性情况下直接控制VThf是可行的。与不采用VG模式时不同，不同的吸呼比也可以不同方式改变高频振荡通气联合VG期间二氧化碳清除的效果。最后，该技术在新生儿中的临床应用表明，使用极高频结合恒定的极低VThf可降低与呼吸机相关的肺损伤风险。
