Boix J H, Tejeda M, Alvarez F, Ernesto E, Bertomeu F, Bañó M
Unidad de Medicina Intensiva, Hospital Gran Via, Castellón de la Plana.
Rev Clin Esp. 1995 Oct;195(10):678-83.
The external high frequency oscillation around a negative baseline (EHFO-NB) is a new mode of non-invasive ventilatory support which could replace or complement nasal intermittent positive pressure ventilation (NIPPV) for treatment of patients with chronic obstructive pulmonary disease, both in the decompensation phases and as preventive measure in intercrisis periods. This was a prospective study in which tolerance and short term effects on acid-base balance and gas interchange of both NIPPV and EHFO-NB in twenty patients with severe chronic obstructive pulmonary disease were compared. With both methods similar decrease in PaCO2 and increases in pH were observed, with decrease and increase in respiratory frequency when using NIPPV and EHFO-NB, respectively; the latter in association with the high oscillation frequencies used. While an improvement of SaO2 and no changes in PaO2 and intrapulmonary shunt were observed on NIPPV, a decrease was observed in the SaO2 and an increase in the shunt on EHFO-NB. Comfort of patients, improvement of perceived sensation of dyspnea, and the absence of complications were similar with both methods. While on NIPPV, 75 per cent of patients required a short period of training and continuous supervision.
围绕负基线的体外高频振荡（EHFO-NB）是一种新的无创通气支持模式，在慢性阻塞性肺疾病患者失代偿期治疗以及作为危机间期预防措施时，可替代或补充鼻间歇正压通气（NIPPV）。这是一项前瞻性研究，比较了20例重度慢性阻塞性肺疾病患者使用NIPPV和EHFO-NB时的耐受性以及对酸碱平衡和气体交换的短期影响。两种方法均观察到PaCO2类似下降和pH升高，使用NIPPV时呼吸频率下降，使用EHFO-NB时呼吸频率升高；后者与所使用的高振荡频率有关。NIPPV时观察到SaO2改善且PaO2和肺内分流无变化，而EHFO-NB时观察到SaO2下降和分流增加。两种方法在患者舒适度、呼吸困难感知改善以及无并发症方面相似。使用NIPPV时，75%的患者需要短期培训和持续监督。
