产房内需要有创通气的早产儿采用容量目标性正压通气的可行性
Feasibility of volume targeted- positive pressure ventilation for preterm infants requiring invasive ventilation in the delivery room.
作者信息
Vaidya Ruben, Visintainer Paul, Singh Rachana
机构信息
Department of Pediatrics, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA.
Epidemiology and Biostatistics Research Core, Office of Research, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA.
出版信息
J Perinatol. 2025 Mar 27. doi: 10.1038/s41372-025-02280-7.
BACKGROUND
Positive pressure ventilation (PPV) with high variability in delivered tidal volume (TV) may cause volutrauma. We aimed to assess feasibility of providing Volume Targeted-Positive Pressure Ventilation (VT-PPV) to preterm infants receiving invasive mechanical ventilation via endotracheal tube in the delivery room (DR).
DESIGN/METHODS: TV measurements were available from a respiratory function monitor (RFM) to adjust peak inspiratory pressures to target TV of 4-6 ml/kg for participants in the intervention cohort (VT-PPV). This data was compared with a historic cohort (HC), where providers were blinded from RFM measurements.
RESULTS
With VT-PPV, goal TV (4-6 ml/kg) was provided 40.1% of times (vs. HC:23.6%, p = 0.002); low TV (<4 ml/kg) was provided 8.6% of times (vs. HC:28.1%, p ≤ 0.001). There was no difference in higher TV provided in the two cohorts.
CONCLUSION
Providing VT-PPV in intubated preterm infants may be feasible in DR and may result in increased number of breaths in target range.
背景
潮气量（TV）输送高度可变的正压通气（PPV）可能导致容积伤。我们旨在评估在产房（DR）为经气管插管接受有创机械通气的早产儿提供容量目标性正压通气（VT-PPV）的可行性。
设计/方法：对于干预队列（VT-PPV）的参与者，可从呼吸功能监测仪（RFM）获得潮气量测量值，以调整吸气峰压，使目标潮气量达到4-6 ml/kg。将该数据与历史队列（HC）进行比较，在历史队列中，提供者对RFM测量结果不知情。
结果
采用VT-PPV时，目标潮气量（4-6 ml/kg）的提供次数占40.1%（相比历史队列：23.6%，p = 0.002）；低潮气量（<4 ml/kg）的提供次数占8.6%（相比历史队列：28.1%，p≤0.001）。两个队列中提供的高潮气量无差异。
结论
在产房为插管早产儿提供VT-PPV可能是可行的，并且可能导致目标范围内的呼吸次数增加。
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