Gappa M, Jackson E, Pilgrim L, Costeloe K, Stocks J
Department of Pediatric Pulmonology, Children's Hospital, Medical School Hannover, Germany.
Pediatr Pulmonol. 1996 Aug;22(2):117-24. doi: 10.1002/(SICI)1099-0496(199608)22:2<117::AID-PPUL7>3.0.CO;2-N.
Measurement of esophageal pressure, as a reflection of pleural pressure, is essential for assessment of dynamic lung mechanics in neonates and infants. Conventionally, an esophageal balloon or a fluid-filled catheter is used, but considerable skill is required to obtain accurate results. Both devices have problems, and failure to achieve valid occlusion tests have been reported, particularly in small infants with lung disease. Recently, a flexible #3 French gauge (FG) microtransducer catheter (MTC, Dräger Netherlands) has become available for medical monitoring. We have assessed the accuracy and feasibility of using this device for measuring lung mechanics in 51 spontaneously breathing infants and small children aged 1 day to 24 months (weight 1.35 to 12.0 kg), 9 of whom were healthy neonates, the remainder suffering from a variety of cardio-respiratory diseases, and in 18 sick ventilated infants (weight 0.6 to 4.0 kg). Positioning of the catheter was well tolerated by all infants. The ratio of esophageal to airway opening pressure changes (delta Pes:delta Pao) ranged from 0.94 to 1.09 [mean (SD) 1.013 (0.03)] for the spontaneously breathing infants and from 0.98 to 1.06 [mean (SD) 1.003 (0.02)] In the ventilated infants with no significant difference in this ratio between the two groups (p = 0.16). This new generation of catheter tip pressure transducers may provide a simpler and more reliable tool for assessing transpulmonary pressure changes in infants than has previously been available.
测量食管压力以反映胸膜压力，对于评估新生儿和婴儿的动态肺力学至关重要。传统上，使用食管球囊或充满液体的导管，但需要相当的技巧才能获得准确结果。这两种装置都有问题，并且有报道称未能完成有效的闭塞试验，特别是在患有肺部疾病的小婴儿中。最近，一种灵活的3号法国规格（FG）微传感器导管（MTC，荷兰德尔格公司）已可用于医学监测。我们评估了使用该装置测量51名年龄在1天至24个月（体重1.35至12.0千克）的自主呼吸婴儿和幼儿以及18名患病机械通气婴儿（体重0.6至4.0千克）肺力学的准确性和可行性，其中9名是健康新生儿，其余患有各种心肺疾病。所有婴儿对导管的放置耐受性良好。自主呼吸婴儿的食管压力变化与气道开口压力变化之比（δPes：δPao）范围为0.94至1.09 [平均值（标准差）1.013（0.03）]，机械通气婴儿的该比值范围为0.98至1.06 [平均值（标准差）1.003（0.02）]，两组之间该比值无显著差异（p = 0.16）。与以前可用的方法相比，这种新一代的导管尖端压力传感器可能为评估婴儿的跨肺压力变化提供一种更简单、更可靠的工具。
