Wilson B J, Becker M A, Linton M E, Donn S M
Department of Pediatrics, University of Michigan Health System, Ann Arbor, USA.
J Perinatol. 1998 Nov-Dec;18(6 Pt 1):436-9.
We designed an observational study to test the hypothesis that a comparison of two methods of minute ventilation, spontaneously generated with mechanically generated, would be a useful predictor of readiness for extubation in preterm infants, weighing <2000 gm, who require mechanical ventilation for >24 hours.
This observational study of 35 infants weighing < or = 2000 gm evaluated the comparison of spontaneously generated minute ventilation with mechanically generated minute ventilation to successfully predict readiness for extubation. After reaching entry criteria, infants were extubated if their spontaneously generated minute ventilation (while receiving endotracheal CPAP) was > or = 50% of the mechanically generated minute ventilation during assist/control ventilation.
Of the 35 infants who had a successful trial and were extubated, 30 (86%) remained extubated for at least 24 hours. Of the five infants who failed extubation, four developed apnea and one developed stridor. Thus, a spontaneous minute ventilation of > or = 50% of mechanically generated minute ventilation predicted readiness for extubation in 86% of the patients in this observation.
A spontaneously generated minute ventilation that is > or = 50% of the mechanically generated minute ventilation is an objective predictor of the readiness for extubation in low birth weight infants who have been weaned to modest ventilatory support.
我们设计了一项观察性研究，以检验以下假设：比较两种分钟通气方法，即自主产生的与机械产生的分钟通气，对于体重<2000克且需要机械通气超过24小时的早产儿拔管准备情况将是一个有用的预测指标。
这项对35名体重≤2000克婴儿的观察性研究评估了自主产生的分钟通气与机械产生的分钟通气的比较，以成功预测拔管准备情况。达到纳入标准后，如果婴儿在接受气管内持续气道正压通气（CPAP）时自主产生的分钟通气≥辅助/控制通气期间机械产生的分钟通气的50%，则进行拔管。
在35名试验成功并拔管的婴儿中，30名（86%）至少24小时未再插管。在5名拔管失败的婴儿中，4名出现呼吸暂停，1名出现喘鸣。因此，在本观察中，自主分钟通气≥机械产生的分钟通气的50%可预测86%的患者的拔管准备情况。
自主产生的分钟通气≥机械产生的分钟通气的50%是已撤至适度通气支持的低出生体重婴儿拔管准备情况的客观预测指标。
