Gaylord M S, Thieme R E, Woodall D L, Quissell B J
Pediatrics. 1985 Aug;76(2):219-24.
Due to the high mortality associated with pulmonary interstitial emphysema in the low-birth-weight infant, a method was developed to predict the infants most at risk for death. This information will allow the discriminant selection of patients for future trials of an alternative method of mechanical ventilation, high-frequency ventilation. During a 3-year-period (July 1, 1979 through June 30, 1982), 70 infants were retrospectively analyzed to determine the clinical parameters important in predicting mortality. The infants at highest risk for death included those of younger gestational age, those with birth weight less than 1,500 g (95% of all mortalities), and those that developed pulmonary interstitial emphysema within the first 24 hours of life. Mortality sharply increased in the infants with birth weight less than 1,500 g whose ventilatory requirements exceeded a peak inspiratory pressure of 25 cm H2O on day 1. Morbidity was high in the survivors as evidenced by a 54% incidence of bronchopulmonary dysplasia. With multivariant analysis, it was possible to isolate the variables (birth weight and highest peak inspiratory pressure on day 1) most influential in predicting mortality and to construct a formula for predicting mortality in the infants with birth weight less than 1,500 g. With a subsequent prospective study of 30 infants, the predictive accuracy of the formula was established.
由于低体重儿发生肺间质气肿时死亡率很高，因此开发了一种方法来预测最有可能死亡的婴儿。这些信息将有助于为未来的高频通气这一机械通气替代方法的试验挑选有区别性的患者。在1979年7月1日至1982年6月30日的3年期间，对70名婴儿进行了回顾性分析，以确定预测死亡率的重要临床参数。死亡风险最高的婴儿包括胎龄较小的婴儿、出生体重低于1500克的婴儿（占所有死亡病例的95%）以及在出生后24小时内发生肺间质气肿的婴儿。出生体重低于1500克且在出生第1天通气需求超过吸气峰压25厘米水柱的婴儿死亡率急剧上升。幸存者的发病率很高，支气管肺发育不良的发生率为54%就证明了这一点。通过多变量分析，可以找出对预测死亡率影响最大的变量（出生体重和出生第1天的最高吸气峰压），并构建一个预测出生体重低于1500克婴儿死亡率的公式。通过随后对30名婴儿的前瞻性研究，确定了该公式的预测准确性。
