在早产婴儿的电阻断层扫描评估的区域肺透气上,随着时间的推移对呼吸支的影响
Ernestas Virsilas1, Arunas Valiulis1, Raimondas Kubilius2
1Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, LT-03101 Vilnius, Lithuania.
Medicina (Kaunas, Lithuania)
|March 28, 2024
概括
在婴儿中,以体积为目标的机械通风导致较高的肺阻抗和通风分布,而不是非侵入性支持. 然而,使用非侵入性方法的自发呼吸可以促进对依赖性肺部区域的更好的通风.
科学领域:
- 新生儿医学 新生儿医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗成像医学成像
背景情况:
- 呼吸困扰综合征 (RDS) 通常需要新生儿的呼吸支持.
- 非侵入性通风 (NIV) 是首选的,但当NIV不足时,则使用机械通风.
- 对比通风策略对于优化新生儿呼吸护理至关重要.
研究的目的:
- 在非常低出生体重的婴儿中,将体积向机械通风与非侵入性通风 (CPAP和HFNC) 进行比较.
- 用电阻断层扫描 (EIT) 评估肺机械和区域通风分布.
主要方法:
- 婴儿 (<32周妊娠年龄,>72小时) 被分为侵入性和非侵入性支持组.
- 电阻断层扫描 (EIT) 测量了终端呼气肺阻抗 (EELZ),DeltaZ,异质性和通风分布.
- 测量是在假设卧卧姿势后的0,30和60分钟后进行的.
主要成果:
- 侵袭性通风显示EELZ (p=0.026) 和DeltaZ (p<0.001) 显著高于NIV.
- 肺异质性在NIV组中较高,并且随着时间的推移保持稳定.
- 与侵入性通风相比,NIV在依赖性肺部区域 (p=0.005) 促进了更大的通风.
结论:
- 与NIV相比,以体积为目标的机械通风增加了EELZ和DeltaZ,但减少了肺异质性.
- 通过NIV自发呼吸比机械通风更有效地增强依赖肺部区域的通风.
- 在新生儿的不同呼吸支策略期间,EIT提供了对区域肺部机制的宝贵见解.
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