早产新生儿打喷嚏和哭泣时的呼吸机制。

Mechanics of breathing during sneezing and crying in premature newborns.

作者信息

Javorka K, Tomori Z, Zavarská L

出版信息

Eur J Respir Dis. 1982 Sep;63(5):442-8.

Abstract

In 22 premature newborns the oesophageal pressure, airflow and tidal volume were recorded and the values of various parameters of breathing mechanics were calculated during sneezing and crying. The deep initial inspiration during sneezing occurred in only 20% of the newborns. In the expulsive phase of sneezing, the oesophageal pressure reached the mean value 7.0 +/- 0.3 kPa. The peak expiratory airflow was 0.126 +/- 0.005 1Xs-1 on average: 6.6 times higher than the flow during quiet breathing. The dynamic compliance in this phase decreased from 28.9 +/- 0.5 to 19.3 +/- 2.2 ml X kPa-1 (P less than 0.01), and the total pulmonary resistance increased markedly from 7.9 +/- 1.0 to 50.0 +/- 0.7 kPaX1(-1)Xs (P less than 0.001). On crying the respiratory rate decreased and the inspiration/expiration ratio changed from 1:1.46 to 1:5.1 (P less than 0.001). The change in the ratio was due to the shortening of inspiration as well as the prolongation of expiration. The mean values of oesophageal pressure were -2.9 +/- 0.4 kPa in the inspiratory phase of crying, and 3.7 +/- 0.2 kPa in the expiratory phase. The ventilation during crying increased by 255% in comparison to the quiet ventilation. The dynamic compliance decreased to 13.9 +/- 1.8 mlXkPa-1 and the total pulmonary resistance rose to 26.5 +/- 2.4 kPaX1(-1)Xs.

摘要

对22名早产新生儿记录其食管压力、气流和潮气量，并计算打喷嚏和哭闹时呼吸力学的各项参数值。打喷嚏时仅20%的新生儿出现深度初始吸气。在打喷嚏的呼气阶段，食管压力达到平均值7.0±0.3 kPa。呼气气流峰值平均为0.126±0.005 l·s⁻¹，比安静呼吸时的气流高6.6倍。此阶段动态顺应性从28.9±0.5降至19.3±2.2 ml·kPa⁻¹（P<0.01），总肺阻力从7.9±1.0显著增加至50.0±0.7 kPa·l⁻¹·s（P<0.001）。哭闹时呼吸频率降低，吸气/呼气比从1:1.46变为1:5.1（P<0.001）。该比值变化是由于吸气缩短以及呼气延长。哭闹吸气阶段食管压力平均值为-2.9±0.4 kPa，呼气阶段为3.7±0.2 kPa。与安静通气相比，哭闹时通气量增加了255%。动态顺应性降至13.9±1.8 ml·kPa⁻¹，总肺阻力升至26.5±2.4 kPa·l⁻¹·s。