Thibeault D W, Hall F K, Sheehan M B, Hall R T
Am J Obstet Gynecol. 1984 Oct 15;150(4):393-9. doi: 10.1016/s0002-9378(84)80146-5.
The pulmonary course and respiratory management of 65 asphyxiated infants with at least one arterial pH less than or equal to 7.00 within the first 2 hours of life was determined. Asphyxia in the preterm and term infants in the absence of respiratory distress syndrome or meconium aspiration syndrome was associated with a transient respiratory insufficiency requiring assisted ventilation which markedly improved in the first 24 hours of life. In contrast, infants with asphyxia complicated by respiratory distress syndrome or meconium aspiration syndrome developed profound lung disease including pulmonary hemorrhage and persistence of the fetal circulation. The course of their illness was significantly worse than control infants without asphyxia. Ineffective neonatal resuscitation allowing for the development of meconium aspiration syndrome and persistent respiratory acidosis contributed to the severity of illness in more than 50% of the infants. Central nervous system pathologic conditions were present in asphyxiated infants with and without severe pulmonary disease. We conclude that severe asphyxia in the absence of underlying lung disease results in a predictable postasphyxial transient respiratory insufficiency, with marked improvement in the first 24 hours of life.
对65例出生后2小时内至少有一次动脉血pH值小于或等于7.00的窒息婴儿的肺部病程及呼吸管理情况进行了测定。早产和足月婴儿在无呼吸窘迫综合征或胎粪吸入综合征的情况下发生窒息，与需要辅助通气的短暂呼吸功能不全有关，这种情况在出生后的头24小时内明显改善。相比之下，伴有呼吸窘迫综合征或胎粪吸入综合征的窒息婴儿会发展为严重的肺部疾病，包括肺出血和持续的胎儿循环。他们的病程明显比无窒息的对照婴儿更差。超过50%的婴儿因无效的新生儿复苏导致胎粪吸入综合征和持续性呼吸性酸中毒，从而加重了病情的严重程度。有严重肺部疾病和无严重肺部疾病的窒息婴儿均存在中枢神经系统病理状况。我们得出结论，在无潜在肺部疾病的情况下，严重窒息会导致可预测的窒息后短暂呼吸功能不全，在出生后的头24小时内会有明显改善。
