Madsen L P, Ebbesen F
Aalborg Sygehus, børneafdelingen.
Ugeskr Laeger. 1998 Jul 6;160(28):4189-93.
Ventilator-induced lung injuries remain an important factor regarding morbidity and mortality in newborns requiring assisted ventilation. Numerous different modes of ventilation have been tried without achieving recognition. High-frequency oscillatory ventilation (HFO) is a new mode of ventilation which employs active inspiration and expiration at frequencies up to 20 Hz with a tidal volume below dead space. Progression of severe respiratory distress syndrome may be reduced by applying early HFO beside modern treatment modes. It has been demonstrated that immediate initial treatment of premature babies with high tidal volumes can cause lung damage. Clinical studies of HFO indicate, that it is possible to improve oxygenation, reduce short-term mortality, surfactant redosing, ventilator-time, use of extra corporeal membrane oxygenation (ECMO) and costs of hospitalization. Morbidity related to lung injury and cerebral damage is apparently unchanged compared to conventional mechanical ventilation. The use of HFO in milder cases awaits further clinical studies.
对于需要辅助通气的新生儿，呼吸机诱导的肺损伤仍然是影响发病率和死亡率的重要因素。人们尝试了许多不同的通气模式，但都未得到认可。高频振荡通气（HFO）是一种新的通气模式，它以高达20赫兹的频率进行主动吸气和呼气，潮气量低于死腔。在现代治疗模式的基础上早期应用HFO可减轻严重呼吸窘迫综合征的进展。已经证明，对早产儿立即采用高潮气量进行初始治疗会导致肺损伤。HFO的临床研究表明，它有可能改善氧合、降低短期死亡率、减少表面活性剂再给药、缩短通气时间、减少体外膜肺氧合（ECMO）的使用以及降低住院费用。与传统机械通气相比，与肺损伤和脑损伤相关的发病率显然没有变化。在较轻病例中使用HFO尚需进一步的临床研究。
