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调整呼吸机设置以防止在正压通气时主动呼气。

Manipulation of ventilator settings to prevent active expiration against positive pressure inflation.

作者信息

Field D, Milner A D, Hopkin I E

出版信息

Arch Dis Child. 1985 Nov;60(11):1036-40. doi: 10.1136/adc.60.11.1036.

DOI:10.1136/adc.60.11.1036
PMID:3935053
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1777637/
Abstract

Recent publications have suggested that in infants receiving artificial ventilatory support a particular pattern of interaction between spontaneous breaths and ventilator inflations (active expiration against each ventilator inflation) may be important in the production of pneumothoraces. We have looked at patterns of interaction from 47 preterm infants studied on 51 occasions. We found that active expiration against the ventilator occurred on a total of 16 occasions. This pattern was prevented on 14 occasions by altering the ventilator settings. In two other babies, the pattern persisted but neither baby developed a pneumothorax.

摘要

最近的出版物表明，在接受人工通气支持的婴儿中，自发呼吸与通气机充气之间的一种特定相互作用模式（每次通气机充气时主动呼气）可能在气胸的发生中起重要作用。我们观察了47例早产儿在51个不同时段的相互作用模式。我们发现，共有16个时段出现了对抗通气机的主动呼气。通过改变通气机设置，在14个时段预防了这种模式。在另外两个婴儿中，这种模式持续存在，但两个婴儿均未发生气胸。

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Arch Dis Child. 1985 Nov;60(11):1036-40. doi: 10.1136/adc.60.11.1036.
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本文引用的文献

1
Prospective clinical comparison of two methods for mechanical ventilation of neonates: rapid rate and short inspiratory time versus slow rate and long inspiratory time.两种新生儿机械通气方法的前瞻性临床比较：快速频率和短吸气时间与慢速频率和长吸气时间。
J Pediatr. 1981 Jun;98(6):957-61. doi: 10.1016/s0022-3476(81)80604-x.
2
Interaction of spontaneous respiration with artificial ventilation in preterm babies.
J Pediatr. 1983 Nov;103(5):769-73. doi: 10.1016/s0022-3476(83)80483-1.
3
Pancuronium prevents pneumothoraces in ventilated premature babies who actively expire against positive pressure inflation.泮库溴铵可预防在正压通气时主动呼气的机械通气早产儿发生气胸。
Lancet. 1984 Jan 7;1(8367):1-3. doi: 10.1016/s0140-6736(84)90177-6.
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Calculation of mean airway pressure during neonatal intermittent positive pressure ventilation and high frequency positive pressure ventilation.新生儿间歇性正压通气和高频正压通气期间平均气道压力的计算。
Pediatr Pulmonol. 1985 May-Jun;1(3):141-4. doi: 10.1002/ppul.1950010304.
5
Inspiratory time and tidal volume during intermittent positive pressure ventilation.间歇性正压通气期间的吸气时间和潮气量。
Arch Dis Child. 1985 Mar;60(3):259-61. doi: 10.1136/adc.60.3.259.