Kamper J, Nielsen G, Erichsen G, Filtenborg J A, Lillquist K, Pedersen V F, Skjoldå J, Stabell I
Acta Anaesthesiol Scand. 1983 Feb;27(1):1-4. doi: 10.1111/j.1399-6576.1983.tb01894.x.
During a 20-month period, 20 infants with idiopathic respiratory distress syndrome (IRDS) were treated with continuous positive airway pressure (CPAP) when they required at least 40% inspired oxygen. The infants were allocated to monitoring with either repeated blood-gas determinations according to the usual practice or continuous transcutaneous PO2 measurements supplemented by blood-gas measurements only when judged necessary. The groups were comparable with regard to birth weight and gestational age, and did not differ significantly with regard to effectiveness or duration of the CPAP treatment, survival rates (90 versus 80%) or number of complications. None developed retrolental fibroplasia. However, PtcO2 monitoring resulted in significantly less hypo- and hyperoxaemia and the number of blood-gas analyses performed during CPAP therapy amounted to only 0.6 per infant per day in the transcutaneously monitored group as against 5.3 in the other group. We propose that PtcO2 monitoring should now be the method of choice and that the use of umbilical artery catheterization should be restricted to selected groups of very low birth-weight infants and to infants in need of ventilator therapy.
在20个月的时间里，20名患有特发性呼吸窘迫综合征（IRDS）的婴儿在需要至少40%的吸入氧时接受持续气道正压通气（CPAP）治疗。这些婴儿被分配为两组，一组按照常规做法进行重复血气测定监测，另一组进行经皮氧分压（PtcO2）连续测量，仅在必要时辅以血气测量。两组在出生体重和胎龄方面具有可比性，在CPAP治疗的有效性、持续时间、存活率（90%对80%）或并发症数量方面没有显著差异。无一例发生晶状体后纤维增生。然而，经皮氧分压监测导致低氧血症和高氧血症明显减少，在经皮监测组中，CPAP治疗期间每个婴儿每天进行的血气分析次数仅为0.6次，而另一组为5.3次。我们建议，现在应选择经皮氧分压监测方法，并且脐动脉插管应仅限于极低出生体重儿的特定群体以及需要机械通气治疗的婴儿。
