Bhutani V K, Ritchie W G, Shaffer T H
Am J Dis Child. 1986 May;140(5):449-52. doi: 10.1001/archpedi.1986.02140190059026.
Proximal airways are compliant structures at early gestational ages and may be susceptible to pressure-induced deformation following prolonged ventilatory support. Sixteen neonates (mean +/- SD gestational age, 27.0 +/- 0.6 weeks; mean +/- SD birth weight, 847 +/- 68 g) were studied to assess tracheal volume deformation. The neonates received ventilatory support for a mean +/- SD duration of 25.4 +/- 4.9 days. During this period the maximum peak inspiratory pressures ranged from 15 to 25 cm H2O, and respirations ranged from 20/min to 60/min. These neonates were studied at seven days postextubation and were individually matched for body weight with 16 nonventilated neonates. The width of the tracheal air column was measured at the lower border of the first thoracic (T-1) and third thoracic (T-3) vertebrae. The average tracheal width (average of T-1 and T-3) was significantly (38%) wider in the ventilated group, and the mean +/- SD tracheal width values were 3.79 +/- 0.29 mm, as compared with the control values of 2.74 +/- 0.31 mm. Based on these data it was estimated that the tracheal volume was 91% greater in the ventilated group. These observations demonstrate tracheal volume deformation and acquired tracheomegaly in neonates who have received mechanical ventilatory support. In addition to increased dead space ventilation, these findings also indicate underlying mechanical deformation of the tracheal wall.
在孕早期，近端气道是顺应性结构，在长时间通气支持后可能易受压力诱导的变形影响。对16例新生儿（平均±标准差胎龄，27.0±0.6周；平均±标准差出生体重，847±68 g）进行研究以评估气管容积变形。这些新生儿接受通气支持的平均±标准差时长为25.4±4.9天。在此期间，最大吸气峰压范围为15至25 cm H₂O，呼吸频率范围为20次/分钟至60次/分钟。在拔管后7天对这些新生儿进行研究，并将其与16例未通气的新生儿按体重进行个体匹配。在第一胸椎（T-1）和第三胸椎（T-3）椎体下缘测量气管气柱宽度。通气组的平均气管宽度（T-1和T-3的平均值）显著增宽（38%），平均±标准差气管宽度值为3.79±0.29 mm，而对照组值为2.74±0.31 mm。基于这些数据估计，通气组的气管容积大91%。这些观察结果表明，接受机械通气支持的新生儿存在气管容积变形和后天性气管扩大。除了无效腔通气增加外，这些发现还表明气管壁存在潜在的机械变形。
