Wren W S
Br J Anaesth. 1983 Jun;55(6):575-80. doi: 10.1093/bja/55.6.575.
A 4.2-kg full-term male infant underwent treatment of acute respiratory distress as a result of gross bilateral pneumothoraces, pneumomediastinum and interstitial emphysema. When a trial of continuous positive airway pressure failed conventional intermittent positive pressure ventilation was instituted, but this also failed to achieve satisfactory ventilation at a respiratory frequency of 60 b.p.m. while producing peak airway pressures of 30 cmH2O. High frequency positive pressure ventilation was instituted with a Siemens 900C ventilator delivering a minute volume of 3 litre min-1 at a respiratory frequency of 72 b.p.m., while registering peak airway pressures in the range of 20-23 cm H2O. During the first 30 min of this regimen the patient's condition improved such that FIO2 was decreased to 0.6. Six hours later FIO2 was decreased to 0.55 and the inspired minute volume to 2.8 litre min-1 with a further decrease in peak airway pressure. The infant was maintained on high frequency positive pressure ventilation for a total of 42 h, and following weaning made an uneventful recovery. In another newborn infant, weight 1.9 kg, the measurement of airway pressure at the distal end of the tracheal tube and gas flow in the inspiratory limb of the respiratory circuit established that the tracheal peak airway pressure was 10 cm H2O less that the pressure registered on the ventilator. The 900C ventilator produced a pattern of high frequency low pressure ventilation, with sustained PEEP, which closely resembles the defined pattern of HFPPV.
一名4.2千克的足月男婴因双侧严重气胸、纵隔气肿和间质性肺气肿接受了急性呼吸窘迫治疗。持续气道正压通气试验失败后，开始采用传统的间歇正压通气，但在呼吸频率为60次/分钟时，气道峰值压力达到30厘米水柱，仍未能实现满意的通气。使用西门子900C呼吸机进行高频正压通气，呼吸频率为72次/分钟，分钟通气量为3升/分钟，气道峰值压力在20 - 23厘米水柱范围内。在该治疗方案的前30分钟内，患者病情改善，使得吸入氧浓度降至0.6。6小时后，吸入氧浓度降至0.55，吸入分钟通气量降至2.8升/分钟，气道峰值压力进一步降低。该婴儿接受高频正压通气共42小时，脱机后恢复顺利。在另一名体重1.9千克的新生儿中，测量气管导管远端的气道压力和呼吸回路吸气支中的气体流量发现，气管峰值气道压力比呼吸机记录的压力低10厘米水柱。900C呼吸机产生了一种高频低压通气模式，并伴有持续呼气末正压，与定义的高频正压通气模式非常相似。
