Durbin G M, Hunter N J, McIntosh N, Reynolds E O, Wimberley P D
Arch Dis Child. 1976 Mar;51(3):163-9. doi: 10.1136/adc.51.3.163.
A controlled trial of elective intervention with continuous inflating pressure (CIP) was performed in infants with severe hyaline membrane disease who weighed more than 1000 g at birth. Infants entered the trial if their arterial oxygen tension (PaO2) fell below 60 mmHg while breathing a fractional inspired oxygen concentration (F1O2) greater than 0-95. 11 out of 12 infants in the CIP-treated group and 10 out of 12 in the control group survived. 7 treated and 6 control infants required mechanical ventilation. When CIP was started the Pao2 of the treated infants increased, and they breathed high concentrations of oxygen for a significantly shorter period than the control infants. During the 31-month duration of the trial 107 other infants with severe hyaline membrane disease were admitted who did not meet the criteria for entry to the trial. 37 survived after breathing high concentrations of oxygen (F1O2 greater than 0-60) spontaneously without any ventilatory assistance, and the remaining 70 infants were already being ventilated on their arrival in the unit, usually because they had required mechanical ventilation during transfer from other hospitals. The neonatal survival rate for those infants born in this hospital during the study period was 88% (50 out of 57 infants) and for those referred from other hospitals it was 69% (51 out of 74 infants). The maximum further increase in overall survival rate that might have been achieved in our population of infants if CIP had been initiated very early in the course of the illness was 5%--i.e. from 77% (101/131) to 82% (107/131).
对出生体重超过1000克的重症透明膜病婴儿进行了持续充气压力（CIP）选择性干预的对照试验。如果婴儿在吸入氧分数（F1O2）大于0.95的情况下呼吸时动脉血氧分压（PaO2）低于60mmHg，则进入试验。CIP治疗组的12名婴儿中有11名存活，对照组的12名婴儿中有10名存活。7名治疗组婴儿和6名对照组婴儿需要机械通气。开始使用CIP时，治疗组婴儿的PaO2升高，且他们吸入高浓度氧气的时间明显短于对照组婴儿。在为期31个月的试验期间，另外107名患有重症透明膜病的婴儿因不符合试验入选标准而入院。37名婴儿在未接受任何通气辅助的情况下自发吸入高浓度氧气（F1O2大于0.60）后存活，其余70名婴儿入院时已在接受通气，通常是因为他们在从其他医院转运期间需要机械通气。研究期间在本院出生的婴儿的新生儿存活率为88%（57名婴儿中的50名），从其他医院转诊而来的婴儿的存活率为69%（74名婴儿中的51名）。如果在疾病早期就开始使用CIP，我们的婴儿群体总体存活率可能实现的最大进一步提高为5%，即从77%（101/131）提高到82%（107/131）。
