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初始通风模式与严重先天性隔膜的医院结果之间的关联
K Taylor Wild1, Leny Mathew2, Anne M Ades3
1Division of Neonatology, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA. wildk@chop.edu.
概括
在分娩室的高频振荡通风 (HFOV) 改善了患有严重先天性隔膜 (CDH) 的婴儿的早期血气交换. 这种方法并没有对其他医院结果产生负面影响,例如生存率或通风持续时间.
科学领域:
- 新生儿医学 新生儿医学
- 儿科手术 儿科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- kongenital diaphragmatic hernia (CDH) 是一种严重的疾病,需要在出生时提供呼吸支持.
- 在分娩室 (DR) 中初始的呼吸器选择可能会影响新生儿的结果.
研究的目的:
- 为了比较初始分娩室 (DR) 呼吸器策略 (传统机械通风 (CMV) 与高频振荡通风 (HFOV)) 与严重CDH的婴儿的医院结果之间的关联.
主要方法:
- 采用了一种准实验性的,前后研究设计.
- 该研究引入了一项促进HFOV的临床方案.
- 主要结局是初始血液气体参数;次要结局包括ECMO,存活率,通风持续时间和住院时间.
主要成果:
- 与接受CMV的婴儿相比,初始接受HFOV的婴儿表现出更有利的初始pH和CO2水平.
- 调整后的分析显示,HFOV和CMV组在ECMO,存活率,通风持续时间或住院时间方面没有显著差异.
结论:
- 在分娩室的初始HFOV与严重CDH的婴儿早期气体交换的改善有关.
- 这一策略并没有导致医院关键结果的不良差异.
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