为需要在产房进行有创通气的早产儿实施容量目标正压通气的可行性。

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-03-27 DOI:10.1038/s41372-025-02280-7

Ruben Vaidya, Paul Visintainer, Rachana Singh

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引用次数: 0

摘要

背景：正压通气（PPV）在输送潮气量（TV）变化大的情况下可能导致容积损伤。我们的目的是评估在产房（DR）接受气管内插管有创机械通气的早产儿提供容积定向正压通气（VT-PPV）的可行性。设计/方法：通过呼吸功能监测仪（RFM）测量TV值，对干预队列（VT-PPV）的参与者调整峰值吸气压力至目标TV值为4-6 ml/kg。该数据与历史队列（HC）进行了比较，在HC中，提供者对RFM测量进行了盲法研究。结果：VT-PPV提供目标TV （4 ~ 6 ml/kg）的次数为40.1% (vs. HC:23.6%, p = 0.002)；结论：给插管早产儿提供VT-PPV可能是可行的，并可能导致目标范围内呼吸次数的增加。

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Feasibility of volume targeted- positive pressure ventilation for preterm infants requiring invasive ventilation in the delivery room.

Background: Positive pressure ventilation (PPV) with high variability in delivered tidal volume (TV) may cause volutrauma. We aimed to assess feasibility of providing Volume Targeted-Positive Pressure Ventilation (VT-PPV) to preterm infants receiving invasive mechanical ventilation via endotracheal tube in the delivery room (DR).

Design/methods: TV measurements were available from a respiratory function monitor (RFM) to adjust peak inspiratory pressures to target TV of 4-6 ml/kg for participants in the intervention cohort (VT-PPV). This data was compared with a historic cohort (HC), where providers were blinded from RFM measurements.

Results: With VT-PPV, goal TV (4-6 ml/kg) was provided 40.1% of times (vs. HC:23.6%, p = 0.002); low TV (<4 ml/kg) was provided 8.6% of times (vs. HC:28.1%, p ≤ 0.001). There was no difference in higher TV provided in the two cohorts.

Conclusion: Providing VT-PPV in intubated preterm infants may be feasible in DR and may result in increased number of breaths in target range.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.