Eyal F G, Arad I D, Godder K, Robinson M J
Crit Care Med. 1984 Sep;12(9):793-7. doi: 10.1097/00003246-198409000-00025.
Twenty-five newborn infants with severe respiratory failure responding poorly to conventional mechanical ventilation were switched to high-frequency positive-pressure ventilation (HFPPV) at 90 to 180 cycle/min (mean 158), an estimated tidal volume less than or equal to 3 ml/kg body weight, an inspiratory time of 0.1 sec, and a PEEP of 3 to 17 cm H2O. In all infants, HFPPV increased PaO2 (mean 66 torr) and decreased PaCO2 (mean 14 torr) within 1 h. Fourteen hours after onset of treatment, the FIO2 requirement had decreased from 1.0 to 0.6 in all infants. Mean airway pressure (Paw) with HFPPV was usually less than or equal to Paw during conventional ventilation. In spite of the often high level of PEEP used, pneumothorax occurred in only 2 infants and bronchopulmonary dysplasia in 1. Eighteen (72%) infants survived and none died of respiratory failure. The use of HFPPV might be beneficial in neonates with severe respiratory failure that responds poorly to conventional therapy.
25例对传统机械通气反应不佳的重症呼吸衰竭新生儿转而采用高频正压通气（HFPPV），频率为90至180次/分钟（平均158次），估计潮气量小于或等于3毫升/千克体重，吸气时间为0.1秒，呼气末正压（PEEP）为3至17厘米水柱。在所有婴儿中，HFPPV在1小时内使动脉血氧分压（PaO2）升高（平均66托），动脉血二氧化碳分压（PaCO2）降低（平均14托）。治疗开始14小时后，所有婴儿的吸入氧分数（FIO2）需求从1.0降至0.6。HFPPV时的平均气道压（Paw）通常小于或等于传统通气时的Paw。尽管使用的PEEP水平常常较高，但仅2例婴儿发生气胸，1例发生支气管肺发育不良。18例（72%）婴儿存活，无一例死于呼吸衰竭。对于对传统治疗反应不佳的重症呼吸衰竭新生儿，使用HFPPV可能有益。
