气道压力释放通气与高频振荡通气在难治性呼吸衰竭新生儿中的比较。
Comparison of Airway Pressure Release Ventilation to High-Frequency Oscillatory Ventilation in Neonates with Refractory Respiratory Failure.
作者信息
Arya Shreyas, Kingma Melissa L, Dornette Stacey, Weber Amy, Bardua Cathy, Mierke Sarah, Kingma Paul S
机构信息
Department of Neonatal/Perinatal Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.
The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
出版信息
Int J Pediatr. 2022 May 2;2022:7864280. doi: 10.1155/2022/7864280. eCollection 2022.
BACKGROUND
Airway pressure release ventilation (APRV) is a relatively new mode of ventilation in neonates. We hypothesize that APRV is an effective rescue mode in infants failing conventional ventilation and it is comparable in survival rates to rescue with high-frequency oscillatory ventilation (HFOV).
METHODS
This is a 6-year retrospective cohort study of infants that failed synchronized intermittent mandatory ventilation (SIMV) and were rescued with either APRV or HFOV. For comparison, we divided infants into two groups (28-37 and >37 weeks) based on their corrected gestational age (CGA) at failure of SIMV.
RESULTS
Ninety infants were included in the study. Infants rescued with APRV ( = 46) had similar survival rates to those rescued with HFOV ( = 44)-28-37 weeks CGA (APRV 78% vs. HFOV 84%, = 0.68) and >37 weeks CGA (APRV 76% vs. HFOV 72%, = 0.74). Use of APRV was not associated with an increase in pneumothorax (APRV 0% and HFOV 10%, = 0.31, in 28-37 weeks CGA, and APRV 0% and HFOV 4%, = 0.22, in >37 weeks CGA).
CONCLUSION
APRV can be effectively used to rescue infants with refractory respiratory failure on SIMV. When compared to HFOV, rescue with APRV is not associated with an increase in mortality or pneumothorax.
背景
气道压力释放通气（APRV）是新生儿一种相对较新的通气模式。我们假设APRV是对常规通气失败的婴儿有效的挽救模式，并且其生存率与高频振荡通气（HFOV）挽救相当。
方法
这是一项对同步间歇指令通气（SIMV）失败并接受APRV或HFOV挽救的婴儿进行的6年回顾性队列研究。为了进行比较，我们根据SIMV失败时的矫正胎龄（CGA）将婴儿分为两组（28 - 37周和>37周）。
结果
90名婴儿纳入研究。接受APRV挽救的婴儿（n = 46）与接受HFOV挽救的婴儿（n = 44）生存率相似——矫正胎龄28 - 37周（APRV 78% 对比HFOV 84%，P = 0.68）以及矫正胎龄>37周（APRV 76% 对比HFOV 72%，P = 0.74）。使用APRV与气胸增加无关（矫正胎龄28 - 37周时，APRV为0%，HFOV为10%，P = 0.31；矫正胎龄>37周时，APRV为0%，HFOV为4%，P = 0.22）。
结论
APRV可有效用于挽救SIMV上难治性呼吸衰竭的婴儿。与HFOV相比，APRV挽救与死亡率增加或气胸无关。
Zotero 插件