Aebischer C C, Kraemer R
Department of Pediatrics, University of Berne, Inselspital, Switzerland.
Agents Actions Suppl. 1993;40:73-83. doi: 10.1007/978-3-0348-7385-7_7.
Assessment of respiratory function is indispensable for provision and control of respiratory care in infants and children with lung disease. Based on plethysmographic measurements and the multibreath nitrogen washout (MBNW) distinction of patients with cystic fibrosis (CF) into different functional groups revealed that the mixed type (TGV > 130 % pred. and Raw > 130 % pred.) has to be considered as worst: highest degree of trapped gases (TG) and ventilation inequalities and consequently most impeded gas exchange. Best predictor in patients with abnormal gas exchange are the degree of bronchial obstruction (Raw) and the amount (TG). Vital capacity (VC) as overall estimate of lung function is best predicted by TG, FEV1 and MEF50. The major merit of the MBNW technique is the possibility to have the amount of TG estimated. Based on the present the calculation of the LCI adds no further information of sufficient clinical importance, remaining the question open, whether the assessment of the so called "moment ratios" from the entire washout curve would feature a better estimate of disturbed lung physiology.
对患有肺部疾病的婴幼儿进行呼吸护理的提供与控制时，呼吸功能评估必不可少。基于体积描记法测量以及多次呼吸氮洗脱（MBNW），将囊性纤维化（CF）患者区分为不同功能组的结果显示，混合型（TGV>预测值的130%且Raw>预测值的130%）必须被视为最差情况：气体潴留（TG）程度最高、通气不均，因此气体交换受阻最严重。气体交换异常患者的最佳预测指标是支气管阻塞程度（Raw）和气体潴留量（TG）。肺活量（VC）作为肺功能的总体评估指标，最佳预测指标是TG、第一秒用力呼气容积（FEV1）和最大呼气中期流速50%（MEF50）。MBNW技术的主要优点是能够估算TG量。基于目前的情况，肺清除指数（LCI）的计算并未增加具有足够临床重要性的更多信息，“整个洗脱曲线的所谓‘瞬间比值’评估是否能更好地估计肺生理紊乱”这一问题仍未解决。
