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容量保证高频振荡通气对呼吸窘迫综合征早产儿的疗效及其对大脑中动脉脑血流的影响

[Efficacy of volume-guaranteed high-frequency oscillatory ventilation in preterm infants with respiratory distress syndrome and its impact on cerebral blood flow in the middle cerebral artery].

作者信息

Wang Yue-Yi, Wei Xue-Xu, Yin Hai-Wei, Zhu Hong-Bin

机构信息

Department of Neonatology, Qinhuangdao Maternal and Child Health Hospital, Qinhuangdao, Hebei 066000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2025 Mar 15;27(3):286-292. doi: 10.7499/j.issn.1008-8830.2409030.

Abstract

OBJECTIVES

To investigate the efficacy of volume-guaranteed high-frequency oscillatory ventilation (HFOV-VG) in preterm infants with respiratory distress syndrome (RDS) and its impact on blood flow in the middle cerebral artery (MCA).

METHODS

A prospective study was conducted on 120 preterm infants with RDS who were admitted to the Department of Neonatology at Qinhuangdao Maternal and Child Health Hospital from March 2020 to December 2023. According to the mode of ventilation, the infants were divided into two groups: a conventional mechanical ventilation (CMV) group (60 infants) and an HFOV-VG group (60 infants). The two groups were compared in terms of baseline data, MCA hemodynamic parameters, complications, and outcomes.

RESULTS

Compared with the CMV group, the HFOV-VG group had significantly shorter durations of mechanical ventilation and hospital stay and a significantly higher overall response rate (<0.05). The HFOV-VG group demonstrated significantly better peak systolic velocity, end-diastolic velocity, and mean flow velocity (<0.05). The HFOV-VG group also exhibited significantly lower 28-day mortality rates and lower incidence rates of bronchopulmonary dysplasia and intraventricular hemorrhage than the CMV group (<0.05).

CONCLUSIONS

HFOV-VG can effectively improve cerebral blood perfusion, reduce cerebrovascular resistance, shorten the durations of mechanical ventilation and hospital stay, and enhance overall treatment efficacy. It has significant advantages in reducing the risk of 28-day mortality, bronchopulmonary dysplasia, and intraventricular hemorrhage in preterm infants with RDS.

摘要

目的

探讨容量保证高频振荡通气(HFOV-VG)在呼吸窘迫综合征(RDS)早产儿中的疗效及其对大脑中动脉(MCA)血流的影响。

方法

对2020年3月至2023年12月在秦皇岛市妇幼保健院新生儿科住院的120例RDS早产儿进行前瞻性研究。根据通气模式,将婴儿分为两组:传统机械通气(CMV)组(60例婴儿)和HFOV-VG组(60例婴儿)。比较两组的基线数据、MCA血流动力学参数、并发症和结局。

结果

与CMV组相比,HFOV-VG组的机械通气时间和住院时间显著缩短,总有效率显著更高(<0.05)。HFOV-VG组的收缩期峰值流速、舒张末期流速和平均流速显著更好(<0.05)。HFOV-VG组的28天死亡率以及支气管肺发育不良和脑室内出血的发生率也显著低于CMV组(<0.05)。

结论

HFOV-VG可有效改善脑血流灌注,降低脑血管阻力,缩短机械通气时间和住院时间,提高总体治疗效果。在降低RDS早产儿28天死亡率、支气管肺发育不良和脑室内出血风险方面具有显著优势。

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