Monset-Couchard M, Ferraz de Albuquerque M, Henry E, Moriette G, Bomsel F, Relier J P
Sem Hop. 1982 Apr 29;58(17):1065-71.
Among 1 186 neonates admitted consecutively to the Post-Royal intensive care Unit, 203 had respiratory distress, a chest roentgenogram typical of delayed resorption of lung fluid, and no other findings. Mean gestational age (GA) was 33 weeks and mean birth-weight (BW) was 1 948 g. Hood oxygen alone was used in 129 cases and intubation-ventilation-PEEP in 74 cases (46 of which were intubated before admission). The occurrence of radiological features was similar in ventilated and non-ventilated neonates : ground-glass pattern (70-80% of the cases), increased vascular markings (70-76%) enlarged right fissure (45%), thin lateral pleural density (24%) and normal cardio-thoracic ratio. The analysis of other prognostic factors showed that ventilated neonates had a significantly lower birth weight (1 689 g versus 2 097 g) and a significantly younger gestational age (31.9 versus 33.6). The study of DAa02 in non-ventilated neonates demonstrated wide individual variations, and the possibility of an early normal DAa02 but also of a late abnormal DAa02, with the associated risks of early hyperoxia or prolonged oxygen needs. In ventilated neonates, the mean duration of intubation was 4 days 13 hours; this duration decreased as the birth-weight rose. In view of the major role of BW and GA, the Port-Royal team advocates the direct admission to a neonatal intensive care unit of neonates with delayed resorption of lung fluid and a BW under 2 000 g. In this way, Pa02 can be closely monitored and artificial ventilation is readily available.
在连续入住皇家重症监护病房的1186例新生儿中，203例有呼吸窘迫，胸部X线片显示为肺液延迟吸收的典型表现，且无其他异常发现。平均胎龄（GA）为33周，平均出生体重（BW）为1948克。129例仅使用头罩给氧，74例采用插管-通气-呼气末正压通气（PEEP）（其中46例在入院前已插管）。通气和未通气新生儿的放射学特征出现情况相似：磨玻璃样改变（70%-80%的病例）、血管纹理增多（70%-76%）、右叶间裂增宽（45%）、侧胸膜线密度减低（24%）以及心胸比率正常。对其他预后因素的分析表明，通气新生儿的出生体重显著较低（1689克对2097克），胎龄显著较小（31.9对33.6）。对未通气新生儿的肺泡动脉血氧分压差（DAa02）研究显示个体差异较大，存在早期DAa02正常但后期异常的可能性，以及早期高氧或长期需要吸氧的相关风险。通气新生儿的平均插管时间为4天13小时；该时间随着出生体重的增加而缩短。鉴于出生体重和胎龄的重要作用，皇家团队主张将肺液延迟吸收且出生体重低于2000克的新生儿直接收入新生儿重症监护病房。这样一来，可以密切监测动脉血氧分压（Pa02），并随时进行人工通气。
