Boros S J, Mammel M C, Coleman J M, Lewallen P K, Gordon M J, Bing D R, Ophoven J P
Pediatrics. 1985 Apr;75(4):657-63.
During a 4-year period, 34 neonates were treated with high-frequency jet ventilation (HFJV) using two different HFJV systems. Twenty-three of the neonates had severe pulmonary air leaks, five had congenital left-sided diaphragmatic hernias, and six had end-stage respiratory failure without pulmonary air leaks. The two HFJV systems performed similarly in all pathologic conditions. Following HFJV, arterial blood gas values improved in 28 of the 34 patients (82%). Eleven patients (32%) ultimately survived. Of 23 patients with pulmonary air leaks, 17 (74%) improved, nine (39%) survived. One infant with diaphragmatic hernia and one with end-stage respiratory failure survived. Ten of 12 patients (85%) who died following eight or more hours of HFJV had significant tracheal histopathology in the region of the endotracheal tube tip. The lesions ranged from moderate erythema to severe necrotizing tracheobronchitis with total tracheal obstruction. HFJV can be useful in the treatment of severe pulmonary air leaks in neonates and may prove useful in the treatment of congenital diaphragmatic hernias. However, HFJV produces inflammatory injuries in the proximal trachea. More clinical and laboratory studies are needed to define the relative risks and benefits of this new therapy.
在4年期间，34例新生儿使用两种不同的高频喷射通气（HFJV）系统进行治疗。其中23例新生儿有严重的肺空气泄漏，5例有先天性左侧膈疝，6例有终末期呼吸衰竭但无肺空气泄漏。两种HFJV系统在所有病理情况下表现相似。HFJV治疗后，34例患者中有28例（82%）动脉血气值改善。11例患者（32%）最终存活。23例有肺空气泄漏的患者中，17例（74%）病情改善，9例（39%）存活。1例膈疝婴儿和1例终末期呼吸衰竭婴儿存活。在接受HFJV治疗8小时或更长时间后死亡的12例患者中，10例（85%）在气管插管尖端区域有明显的气管组织病理学改变。病变范围从中度红斑到严重的坏死性气管支气管炎伴气管完全阻塞。HFJV可用于治疗新生儿严重的肺空气泄漏，可能对先天性膈疝的治疗也有用。然而，HFJV会在气管近端产生炎性损伤。需要更多的临床和实验室研究来确定这种新疗法的相对风险和益处。
