侵入性机械通风期间的隔膜缩小与早产婴儿的输出失败有关:超声波研究
Stefano Nobile1, Annamaria Sbordone1, Nicola Salce2
1Department of Mother, Child and Public Health, Division of Neonatology, Neonatal Unit, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.
Pediatric pulmonology
|February 14, 2024
概括
隔膜缩 (DA) 发生在58.8%的机械呼吸的新生儿中,并且与输出失败有关. 在通风开始时,更高的平均气道压力和肺超声波得分与DA相关.
科学领域:
- 新生儿重症监护服务新生儿重症监护服务
- 儿科呼吸系统医学 儿科呼吸系统医学
- 医学超声波 医学超声波
背景情况:
- 隔膜功能障碍是严重病患者的已知并发症.
- 呼吸器诱导的隔膜功能障碍 (VIDD) 和隔膜缩 (DA) 在新生儿中没有得到充分的研究.
- 了解新生儿VIDD对于改善结果至关重要.
研究的目的:
- 评估新生儿呼吸机诱导的隔膜功能障碍 (VIDD) 的发生率和相关性.
- 为了研究隔膜缩 (DA) 和新生儿临床因素之间的关系.
- 探索隔膜超声波在预测输出失败方面的潜力.
主要方法:
- 展望性,单中心研究涉及早产新生儿在侵入性机械通风 (IMV) 上≥2天.
- 隔膜厚度每天用超声波测量,在吸入和呼气结束时.
- 隔膜缩 (DA) 被定义为终端呼气厚度减少≥10%,记录了输出失败和临床数据.
主要成果:
- 隔膜缩 (DA) 在50%的IMV周期 (11/22) 中发生在10名婴儿中,通常是在通风过程的早期.
- 在第一天的IMV中,更高的平均气道压力 (MAP) 和肺超声波得分 (LUS) 与DA相关.
- 与成功输出管的婴儿 (33.3%) 相比,在输出管失败 (83.3%) 的婴儿中,DA的频率明显高.
结论:
- 隔膜缩 (DA) 影响IMV新生儿的很大一部分,并与输出失败密切相关.
- 在IMV开始时MAP和LUS升高可能预测DA的发展.
- 隔膜超声波显示为评估DA和预测新生儿输出管的结果的工具.
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