Fanconi S, Kraemer R, Weber J, Tschaeppeler H, Pfenninger J
J Pediatr. 1985 Feb;106(2):218-22. doi: 10.1016/s0022-3476(85)80290-0.
Nine children surviving severe adult respiratory distress syndrome were studied 0.9 to 4.2 years after the acute illness. They had received artificial ventilation for a mean of 9.4 days, with an Fio2 greater than 0.5 during a mean time of 34 hours and maximal positive end expiratory pressure levels in the range of 8 to 20 cm H2O. Three children had recurrent respiratory symptoms (moderate exertional dyspnea and cough), and two had evidence of fibrosis on chest radiographs. All patients had abnormal lung function; the most prominent findings were ventilation inequalities, as judged by real-time moment ratio analysis of multibreath nitrogen washout curves (abnormal in eight of nine patients) and hypoxemia (seven of nine). Lung volumes were less abnormal; one patient had restrictive and two had obstructive disease. A significant correlation between intensive care measures (Fio2 greater than 0.5 in hours and peak inspiratory plateau pressure) and lung function abnormalities (moment ratio analysis and hypoxemia) was found. A possibly increased susceptibility of the pediatric age group to the primary insult or respiratory therapy of adult respiratory distress syndrome is suggested.
对9名患有严重成人呼吸窘迫综合征且存活下来的儿童在急性疾病发作后0.9至4.2年进行了研究。他们平均接受了9.4天的人工通气，平均34小时内吸入氧分数大于0.5，呼气末正压最大值在8至20厘米水柱范围内。3名儿童有反复出现的呼吸道症状（中度运动性呼吸困难和咳嗽），2名儿童胸部X光片有纤维化迹象。所有患者肺功能均异常；最突出的发现是通气不均，通过多呼吸氮洗脱曲线的实时矩比分析判断（9名患者中有8名异常）和低氧血症（9名中有7名）。肺容量异常程度较轻；1名患者有限制性疾病，2名有阻塞性疾病。发现重症监护措施（吸入氧分数大于0.5的小时数和吸气峰平台压）与肺功能异常（矩比分析和低氧血症）之间存在显著相关性。提示儿童年龄组对成人呼吸窘迫综合征的原发性损伤或呼吸治疗可能易感性增加。
