Hung H Y, Huang F Y, Ho M Y, Kao H A
Department of Pediatrics, Mackay Memorial Hospital Taipei, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1994 Jan-Feb;35(1):36-44.
From July 1987 to October 1991, we experienced 10 full-term newborn infants with severe adult respiratory distress syndrome (ARDS). The triggering events were intrauterine/perinatal asphyxia in 6 and sepsis in 4. All had severe respiratory distress/failure and were mechanically ventilated with high concentration of inspired oxygen and positive end-expiratory pressure. Radiography of the chest all showed bilateral dense consolidation (white out lungs) and reduced lung volume. Persistent pulmonary hypertension (PPHN) was documented in 9 cases (90%). The concomittent occurrence of ARDS and PPHN rendered respiratory management extremely difficult. High-rate ventilation and tolazoline infusion were used in all these 9 PPHN cases. Acute complication of respiratory therapy (pneumothorax) was encountered in 5 patients. Only 3 cases survived, all belonging to the asphyxia group. Of these 3 survivors, 1 developed bronchopulmonary dysplasia, 1 had cerebral palsy on follow up and the other one was lost on follow up. The outcome of neonatal ARDS was generally poor.
1987年7月至1991年10月期间，我们收治了10例患有严重成人呼吸窘迫综合征（ARDS）的足月儿。引发因素为6例宫内/围产期窒息和4例败血症。所有患儿均有严重的呼吸窘迫/衰竭，均接受了高浓度吸氧和呼气末正压通气的机械通气治疗。胸部X线检查均显示双侧致密实变（肺野呈白色）和肺容积减小。9例（90%）记录有持续性肺动脉高压（PPHN）。ARDS和PPHN同时出现使呼吸管理极为困难。所有这9例PPHN患儿均采用了高频通气和静脉滴注妥拉唑啉治疗。5例患者出现了呼吸治疗的急性并发症（气胸）。仅3例存活，均属于窒息组。在这3例幸存者中，1例发展为支气管肺发育不良，1例随访时患有脑瘫，另1例失访。新生儿ARDS的总体预后较差。
