Clark R H, Gerstmann D R, Null D M, Yoder B A, Cornish J D, Glasier C M, Ackerman N B, Bell R E, Delemos R A
Crit Care Med. 1986 Nov;14(11):926-30. doi: 10.1097/00003246-198611000-00002.
Twenty-seven low birth weight infants who developed pulmonary interstitial emphysema (PIE) and respiratory failure while on conventional ventilation were treated with high-frequency oscillatory ventilation (HFOV). The mean birth weight was 1.2 kg (range 0.55 to 2) with gestational age of 28 wk (range 25 to 34). Ten patients died, six of whom had documented sepsis with shock and were therefore excluded from analysis. All patients showed initial improvement on HFOV. Surviving patients showed continued improvement in oxygenation and ventilation at increasingly lower fraction of inspired oxygen and proximal airway pressure with resolution of PIE, while nonsurvivors progressively developed chronic respiratory insufficiency with continued PIE from which recovery was not possible. Overall survival in nonseptic patients was 80% (16 of 20). We found HFOV to be effective in the treatment of PIE and hypothesize that interstitial airleak is decreased during HFOV because adequate ventilation is provided at lower peak distal airway pressures.
27例低出生体重儿在接受传统通气治疗时发生了肺间质肺气肿（PIE）和呼吸衰竭，随后接受了高频振荡通气（HFOV）治疗。平均出生体重为1.2kg（范围0.55至2kg），胎龄为28周（范围25至34周）。10例患者死亡，其中6例记录有败血症伴休克，因此被排除在分析之外。所有患者在接受HFOV治疗后均有初步改善。存活患者在吸入氧分数和近端气道压力越来越低的情况下，氧合和通气持续改善，PIE得到缓解，而非存活患者则逐渐发展为慢性呼吸功能不全，PIE持续存在且无法恢复。非败血症患者的总体生存率为80%（20例中的16例）。我们发现HFOV对PIE的治疗有效，并推测在HFOV期间间质气漏减少，因为在较低的远端气道峰值压力下可提供足够的通气。
