新生儿呼吸支策略 - 短期和长期呼吸结果
Ourania Kaltsogianni1, Theodore Dassios1,2, Anne Greenough1
1Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
Frontiers in pediatrics
|August 11, 2023
概括
新的通风策略,如CPAP和LISA可以减少新生儿的慢性呼吸问题. 需要进一步的研究来证实新方法的长期益处,例如闭环自动化氧气控制.
科学领域:
- 新生儿的呼吸系统支持.
- 预防婴儿肺损伤 预防婴儿肺损伤
背景情况:
- 机械通风 (MV) 可以导致婴儿慢性呼吸道疾病.
- 新的通风模式旨在尽量减少肺损伤.
研究的目的:
- 审查当前和新兴的新生儿呼吸支策略.
- 评估它们在减少肺损伤和发病率方面的有效性.
主要方法:
- 对侵入性和非侵入性呼吸支策略的审查.
- 分析包括少侵入性表面活性剂管理 (LISA) 和闭环自动化氧气控制 (CLAC) 的技术.
- 从随机对照试验 (RCT) 对诸如支气管肺形症 (BPD) 等结局的证据的审查.
主要成果:
- 与MV相比,早期连续正气道压力 (CPAP) 降低了BPD和呼吸道发病率.
- 鼻间歇性正压通风减少了治疗失败,但没有BPD.
- 与输管和表面活性剂输送相比,LISA减少了BPD.
- 针对体积的同步通风减少了被直管的婴儿的BPD.
- 高频振荡通风 (HFOV) 显示了短期的好处,但不是长期的好处.
结论:
- CPAP和LISA有效地减少了新生儿的BPD和呼吸道发病率.
- 对于被直管的婴儿,建议进行同步的,以体积为目标的通风.
- 像CLAC和神经调整呼吸器辅助 (NAVA) 这样的新策略的长期结果需要在强大的RCT中进行进一步的调查.
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