Gerhardt T, Hehre D, Feller R, Reifenberg L, Bancalari E
J Pediatr. 1987 Mar;110(3):448-56. doi: 10.1016/s0022-3476(87)80516-4.
Pulmonary function was measured in 39 infants with chronic lung disease who had required mechanical ventilation starting during the first week of life for a median of 9 days (range 1 to 46 days) and supplemental oxygen for a median of 48 days (range 28-162 days). Their mean birth weight was 1140 g (range 550 to 2325 g), and mean gestational age 29.8 weeks (range 26 to 37 weeks). Ventilation was measured by pneumotachography, esophageal pressure through a water-filled feeding tube, and functional residual capacity (FRC) by a modified nitrogen washout technique. Lung compliance, pulmonary conductance, and FRC were determined at 1, 3, 6, 12, 18, 24, and 36 months after birth. Pulmonary function was also determined in 40 normal children, ranging in age from neonates to 5 years, who served as controls. In infants with chronic lung disease, growth in weight and length followed the 10th to 25th percentiles of the normal curve. Minute ventilation and respiratory effort remained elevated throughout the follow-up. FRC per kilogram of body weight was decreased at 1, 3, and 6 months after birth, but thereafter was in the normal range. FRC increased in proportion to weight at the same rate as in the controls. Lung compliance was only half of normal at 1 month, increased with growth in close correlation with weight, and was approximately 80% of normal at the end of follow-up. Pulmonary conductance was 50% of normal at 1 month, increased little during the first 6 months, but reached 85% of normal at 3 years of age. There was no evidence of gas trapping. These results indicate that in infants with chronic lung disease after mechanical ventilation, lung volume increases normally, probably by formation of new alveoli, which also leads to improvement in lung compliance. Airway growth is slow during the first 6 months after birth, but the subsequent faster growth leads to conductance values close to normal at 3 years of age.
对39例患有慢性肺病的婴儿进行了肺功能测量，这些婴儿在出生后第一周开始需要机械通气，通气时间中位数为9天（范围1至46天），补充氧气时间中位数为48天（范围28 - 162天）。他们的平均出生体重为1140克（范围550至2325克），平均胎龄为29.8周（范围26至37周）。通过呼吸流速仪测量通气，通过充满水的喂食管测量食管压力，并通过改良的氮洗脱技术测量功能残气量（FRC）。在出生后1、3、6、12、18、24和36个月测定肺顺应性、肺传导率和FRC。还对40名年龄从新生儿到5岁的正常儿童进行了肺功能测定，作为对照。患有慢性肺病的婴儿，体重和身长增长遵循正常曲线的第10至25百分位数。在整个随访过程中，分钟通气量和呼吸努力保持升高。出生后1、3和6个月时，每公斤体重的FRC降低，但此后处于正常范围内。FRC与体重成比例增加，速率与对照组相同。肺顺应性在1个月时仅为正常的一半，随生长增加，与体重密切相关，随访结束时约为正常的80%。肺传导率在1个月时为正常的50%，在前6个月增加很少，但在3岁时达到正常的85%。没有气体潴留的证据。这些结果表明，机械通气后的慢性肺病婴儿，肺容积正常增加，可能是通过新肺泡的形成，这也导致肺顺应性改善。出生后前6个月气道生长缓慢，但随后较快的生长导致3岁时传导率值接近正常。
