Singh M, Deorari A K, Paul V K, Mittal M, Shanker S, Munshi U, Jain Y
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Indian Pediatr. 1993 Jun;30(6):783-9.
Ninety neonates were ventilated over a period of 33 months of whom 50 (55.5%) survived. Fifty seven babies received IPPV while 33 CPAP. IPPV mode was being used more frequently recently and survival rates have steadily improved over past 3 years. Survival was cent per cent in babies above 1.5 kg on CPAP mode while 16/26 (57.7%) survived on IPPV mode. Of 22 extremely VLBW (< 1 kg) babies, six survived. HMD was the commonest indication of ventilation (50%), of which 53% (24/45) survived. The other important indications of ventilation were apnea in 13 and transient tachypnea in 11 babies. All babies requiring ventilation for transient tachypnea survived. Nosocomial infections were common in association with ventilation 34/90 (37.7%), out of which in 14 was responsible for about a third of deaths. Pulmonary air leaks developed in 12 babies of which 6 died. Two babies developed BPD and one ROP. Neonatal ventilation should be ventured in centres where basic facilities for level II care already exist. It may not be cost effective to ventilate extremely low birth weight neonates.
90名新生儿在33个月的时间里接受了通气治疗，其中50名（55.5%）存活。57名婴儿接受了间歇正压通气（IPPV），33名接受了持续气道正压通气（CPAP）。最近IPPV模式的使用更为频繁，并且在过去3年中存活率稳步提高。体重超过1.5千克的婴儿采用CPAP模式时存活率为100%，而采用IPPV模式时26名中有16名（57.7%）存活。在22名极低出生体重（<1千克）的婴儿中，6名存活。透明膜病（HMD）是通气治疗最常见的指征（50%），其中53%（24/45）存活。其他重要的通气指征是13名婴儿出现呼吸暂停，11名婴儿出现短暂性呼吸急促。所有因短暂性呼吸急促需要通气的婴儿均存活。医院感染在通气治疗中很常见，90名中有34名（37.7%），其中14名约占死亡人数的三分之一。12名婴儿发生了肺漏气，其中6名死亡。2名婴儿发生了支气管肺发育不良（BPD），1名发生了视网膜病变（ROP）。新生儿通气治疗应在已经具备二级护理基本设施的中心进行。对极低出生体重的新生儿进行通气治疗可能不具有成本效益。
