倾斜位置通风对新生儿在静脉动脉外体膜氧化过程中的肺功能的影响
Kai-Peng Sun1, Si-Jia Zhou1, Xiu-Hua Chen1
1Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
在新生儿外体膜氧化 (ECMO) 期间,俯卧式通风 (PPV) 可能会改善肺功能. 这项研究发现,在接受ECMO支持的新生儿中,PPV显著提高了呼吸合规性,降低了呼吸道阻力.
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
- 身体之外的生命支持.
背景情况:
- 身体外膜氧化 (ECMO) 已降低了肺高血压和呼吸衰竭的新生儿的死亡率.
- 俯卧式通风 (PPV) 是一种用于改善急性呼吸困扰综合征的婴儿的氧化技术.
- 在接受静脉动脉ECMO (VA-ECMO) 的新生儿中,PPV的疗效需要进一步研究.
研究的目的:
- 评估PPV对接受VA-ECMO的新生儿肺功能的影响.
- 为了比较ECMO与PPV的新生儿与ECMO与仰卧式通风 (SPV) 的新生儿之间的呼吸参数.
主要方法:
- 对获得ECMO支持的17名新生儿进行了回顾性分析.
- 患者被分为两个组:ECMO与PPV (n=8) 和ECMO与SPV (n=9).
- 分析了包括P/F比,氧化指数 (OI),呼吸系统合规性 (Crs) 和气道阻力 (RAW) 在内的关键参数.
主要成果:
- 两组都显示了氧化和遵守的逐渐改善,在ECMO期间OI和RAW下降.
- 与ECMO-SPV组相比,ECMO-PPV组在第3天显示Crs和RAW的显著改善 (P<0.05).
- 在ECMO-PPV组中,Crs在启动PPV后2小时内增加,RAW减少,在第3天具有统计学意义.
结论:
- 在新生儿ECMO期间的PPV可以提高呼吸合规性并降低气道阻力.
- 在ECMO的支持下,PPV似乎是改善新生儿肺部恢复的有益策略.
- 在这个队列中没有观察到与PPV相关的严重并发症.
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