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在先天性心脏手术后呼吸衰竭的高频喷气通风
K C Kocis1, J N Meliones, M K Dekeon
1Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor 48109-0204.
Circulation
|November 1, 1992
概括
高频喷气通风 (HFJV) 在先天性心脏手术后的儿科患者中有效治疗呼吸衰竭 (RF),作为体外膜氧化 (ECMO) 的可行替代方案. 这种方法改善了通风和气体交换,89%的患者显示RF的分离.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心胸外科手术 心胸外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 呼吸衰竭 (RF) 是先天性心脏手术后的一个关键并发症.
- 身体外膜氧化 (ECMO) 是持续性RF的救援疗法.
- 传统的机械通风 (CMV) 在严重的射频中可能不足.
研究的目的:
- 评估高频喷气通风 (HFJV) 作为RF先天性心脏手术后ECMO的替代方案.
- 评估HFJV在改善通风和气体交换方面的有效性.
- 要将HFJV参数与CMV进行比较.
主要方法:
- 一组由9名患有先天性心脏病和需要ECMO的RF的儿科患者组成的队列接受了HFJV的治疗.
- 在手术后2周内启动HFJV.
- 在HFJV之前和期间监测了呼吸系统参数和动脉血液气体.
主要成果:
- 在89%的患者 (8人中有9人) 中,HFJV解决了RF.
- 在HFJV1小时后,动脉pH显著增加 (p<0.05) 和PaCO2显著降低 (p<0.05) .
- 与CMV相比,吸入氧气 (FIO2) 分数显著下降 (p < 0.05),平均气道压力 (PAW) 或其他血液动力学参数没有变化.
结论:
- HFJV是先天性心脏手术后儿科患者呼吸衰竭的有效治疗方法.
- HFJV为ECMO提供了一个潜在的拯救生命的替代方案.
- 需要进一步的研究来优化HFJV在这个人群中的使用.
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