高频冲击通气:高频冲击通气:极低妊娠期新生儿严重肺部疾病的有效救治策略

IF 2 4区 医学 Q2 PEDIATRICS
Kevin Louie, Kristina Ericksen, Lance A Parton
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引用次数: 0

摘要

研究目的本研究旨在评估高频冲击通气(HFPV)作为严重肺部疾病极低胎龄新生儿(ELGANs)抢救策略的效果。方法:本研究对 16 例患有严重肺部疾病的 ELGAN 进行了回顾性研究,这些新生儿在使用其他常规和高频通气模式后病情未见好转,因此被安排使用 HFPV。结果:这16名婴儿的胎龄为25(24,26)周,出生体重为640(535,773)克[中位数(IQR)],与死亡婴儿相比,存活婴儿的发育更不成熟[分别为24(23,26)周和26(25,28)周;(P = 0.04)];总死亡率为31%(N = 5)。在死亡病例中,60% 为 SGA(P = 0.02)。在接受 HFPV 治疗后,由于氧合状况的改善[FiO2.0.95 (0.85, 0.95)],存活者的呼吸系统严重程度评分 (RSS) [11 (9, 14) to 6 (5, 13),p = 0.03]与未存活者相比有了显著下降[15 (11, 16) to 11 (6.8, 14.5),p = 0.32]:0.95 (0.85, 1) 到 0.6 (0.4, 0.9),p = 0.01;相比之下,存活者和非存活者分别为 1 (1, 1) 到 1 (0.7, 1);p = 0.32]。胸部 X 光片也显示,由于存活者的肺不张面积减少,通气状况明显改善。结论:对于患有严重肺病的 ELGAN 患者来说,HFPV 可能是一种合适的高频通气抢救模式,尤其是对于因移位性肺偏流和粘液堵塞而导致氧合功能受损和通气困难的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High-Frequency Percussive Ventilation: A Promising Rescue Strategy in Severe Lung Disease of Extremely Low Gestational Age Neonates.

Objective: The aim of this study was to evaluate high-frequency percussive ventilation (HFPV) as a rescue strategy for extremely low gestational age neonates (ELGANs) with severe lung disease. Methods: This is a retrospective review of 16 ELGANs with severe lung disease who were placed on HFPV following a lack of improvement on other modes of conventional and high-frequency ventilation. Results: The gestational age of these 16 infants was 25 (24, 26) weeks and their birth weight was 640 (535, 773) grams [median (IQR)], with the survivors being more immature compared to those who died [24 (23, 26) and 26 (25, 28) weeks, respectively; (p = 0.04)]; and with an overall mortality of 31% (N = 5). Of those who died, 60% were SGA (p = 0.02). Following placement on HFPV, the survivors had a statistically significant decrease in their respiratory severity scores (RSSs) [11 (9, 14) to 6 (5, 13), p = 0.03] compared to those who did not survive [15 (11, 16) to 11 (6.8, 14.5), p = 0.32] due to an improvement in their oxygenation [FiO2: 0.95 (0.85, 1) to 0.6 (0.4, 0.9), p = 0.01; compared to 1 (1, 1) to 1 (0.7, 1); survivors and non-survivors, respectively; p = 0.32]. Chest X-rays also showed significantly improved aeration due to decreased areas of atelectasis in those who survived. Conclusions: HFPV may be an appropriate rescue mode of high-frequency ventilation in the ELGAN population with severe lung disease, particularly for patients with impaired oxygenation and ventilation difficulties due to shifting atelectasis and mucous plugging.

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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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