Hysinger Erik B, Ahlfeld Shawn K
Division of Pulmonary Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Division of Neonatology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Front Pediatr. 2023 Mar 1;11:1087857. doi: 10.3389/fped.2023.1087857. eCollection 2023.
Neonates who are born preterm frequently have inadequate lung development to support independent breathing and will need respiratory support. The underdeveloped lung is also particularly susceptible to lung injury, especially during the first weeks of life. Consequently, respiratory support strategies in the early stages of premature lung disease focus on minimizing alveolar damage. As infants grow and lung disease progresses, it becomes necessary to shift respiratory support to a strategy targeting the often severe pulmonary heterogeneity and obstructive respiratory physiology. With appropriate management, time, and growth, even those children with the most extreme prematurity and severe lung disease can be expected to wean from respiratory support.
早产新生儿的肺部发育往往不足以支持自主呼吸,因此需要呼吸支持。发育不全的肺部也特别容易受到肺损伤,尤其是在出生后的头几周。因此,早产肺病早期阶段的呼吸支持策略侧重于将肺泡损伤降至最低。随着婴儿的成长和肺病的进展,有必要将呼吸支持策略转向针对通常较为严重的肺部异质性和阻塞性呼吸生理的策略。通过适当的管理、时间和成长,即使是那些极早产且患有严重肺病的儿童也有望脱离呼吸支持。