压力控制与压力控制的效率的比较 传统的手动口罩通风用于新生儿复苏 - 一个基于模拟的试点随机控制试验
Shilpa Kalane1, Vaibhavi Upadhye2, Atul V Mulay3
1Department of Neonatology, Deenanath Mangeshkar Hospital, Pune, India. drshilpakalane@gmail.com.
Indian journal of pediatrics
|November 27, 2023
概括
使用通风器 (NIPPmV) 进行非侵入性正压面罩通风,与自膨胀袋或T片复苏器相比,提供更快,更有效的通风. 这种方法确保了持续的呼吸,从而改善了患者的治疗结果.
科学领域:
- 新生儿复苏术 新生儿复苏术
- 呼吸系统辅助设备的使用.
- 医疗通风技术 医疗通风技术
背景情况:
- 在新生儿复苏中,有效的通风是至关重要的.
- 传统的设备,如自充气袋 (SIB) 和T片复苏器 (TPR),在实现连续通风方面存在局限性.
- 非侵入性正压通风 (NIPPV) 是一种需要评估不同输送装置的替代方法.
研究的目的:
- 为了比较非侵入性正压面膜透气使用呼吸器装置 (NIPPmV) 与SIB和TPR进行早期有效通风的疗效.
- 评估关键的通风参数,包括胸部上升的时间,最大吸气压 (PIP) 和通风速率.
主要方法:
- 一项涉及33名训练有素的复苏医生在新生儿玩偶上使用NIPPmV,SIB和TPR进行的比较研究.
- 用视频录像和持续压力监测来评估30秒的通风效率.
- 主要结局:有效的胸部升高的时间. 二次结果:PIP,通风率,以及需要采取纠正措施.
主要成果:
- 与SIB和TPR相比,NIPPmV显著减少了实现第一个胸部升高的时间 (3.0s vs. 3.7s vs. 7.5s,p<0.001).
- 与SIB和TPR相比,NIPPmV提供了更准确的峰值吸气压力,预设值 (19.8 cmH2O与35.6 cmH2O与17.8 cmH2O,p<0.001).
- 与SIB (42次呼吸/分钟) 和TPR (33次呼吸/分钟) 相比,NIPPmV (50次呼吸/分钟) 更准确地控制了通风率,p<0.001.
结论:
- 使用通风器装置 (NIPPmV) 的非侵入性正压面罩通风是实现早期和一致通风的有效方法.
- 与SIB和TPR相比,NIPPmV在速度,压力传递的准确性和通风率控制方面表现出卓越的性能.
- 这些发现表明,NIPPmV是新生儿环境中正压通风的潜在有利方法.
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