中等程度呼吸功能不全新生儿的经鼻高频通气
Nasal high frequency ventilation in neonates with moderate respiratory insufficiency.
作者信息
van der Hoeven M, Brouwer E, Blanco C E
机构信息
Department of Neonatology, Academic Hospital Maastricht, The Netherlands.
出版信息
Arch Dis Child Fetal Neonatal Ed. 1998 Jul;79(1):F61-3. doi: 10.1136/fn.79.1.f61.
Abstract
AIM
To investigate the efficacy of nasal high frequency ventilation (nHFV) in newborn infants with moderate respiratory insufficiency.
METHOD
Twenty one preterm and term neonates were treated with nHFV for respiratory insufficiency. Criteria for starting nHFV were: deterioration on nasal CPAP expressed by a median pH of 7.24 and pCO2 of 8.3 kPa, or increasing FIO2. nHFV was delivered using the Infant Star ventilator. Ventilator setting amplitude was 35 cm H2O; mean airway pressure 7 cm H2O; and frequency 10 Hz.
RESULTS
pCO2 decreased significantly from 8.3 kPa to 7.2 kPa after nHFV was started. In five patients nHFV was discontinued after a median period of 6 1/2 hours due to CO2 retention and high oxygen need, and endotracheal mechanical ventilation was started.
CONCLUSIONS
nHFV can reduce pCO2 in neonates with moderate respiratory insufficiency and, therefore, could be used to decrease the need for endotracheal mechanical ventilation.
摘要
目的
探讨经鼻高频通气（nHFV）治疗中度呼吸功能不全新生儿的疗效。
方法
21例早产和足月新生儿因呼吸功能不全接受nHFV治疗。开始nHFV的标准为：经鼻持续气道正压通气（CPAP）治疗效果恶化，表现为pH值中位数为7.24，二氧化碳分压（pCO2）为8.3kPa，或吸入氧分数（FIO2）增加。使用婴儿之星呼吸机进行nHFV通气。呼吸机设置参数为：振幅35cmH2O；平均气道压7cmH2O；频率10Hz。
结果
开始nHFV后，pCO2从8.3kPa显著降至7.2kPa。5例患者在中位时间6.5小时后因二氧化碳潴留和高氧需求而停止nHFV，并开始进行气管内机械通气。
结论
nHFV可降低中度呼吸功能不全新生儿的pCO2，因此可用于减少气管内机械通气的需求。
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