针对早产婴儿高频振荡式通风的体积定位:系统性审查
Eduardo Antonio de Sousa Orlandin1, Thais Iwashita-Lages1, Luis Kanhiti Oharomari-Junior1
1Hospital das Clínicas de Ribeirão Preto da Universidade de São Paulo, Departamento de Pediatria, Divisão de Terapia Intensiva Neonatal, Ribeirão Preto, SP, Brazil.
Jornal de pediatria
|March 12, 2025
概括
针对体积的高频振荡通风 (HFOV与VT) 可能会降低潮体积的可变性,并减少新生儿的低心血管和高心血管. 需要进一步的随机试验来确认临床益处.
科学领域:
- 新生儿的呼吸系统支持.
- 机械通风策略 机械通风策略
- 新生儿肺部生理学 新生儿肺部生理学
背景情况:
- 高频振荡通风 (HFOV) 是新生儿的关键呼吸辅助方式.
- 传统的HFOV可能会导致由于体积变化而导致肺损伤.
- 量定位 (VT) 旨在在HFOV期间提供一致的潮量.
研究的目的:
- 系统地审查与新生儿常规HFOV相比,使用体积向通风 (VT) 的HFOV的影响.
- 分析与这些通风策略相关的关键呼吸和临床结果.
主要方法:
- 在PubMed,EMBASE,Cochrane和ClinicalTrials.gov.gov的系统文献搜索.
- 包括对新生儿 (<44周校正年龄) 进行静脉治疗和无静脉治疗的HFOV比较的研究.
- 对结果的分析包括潮体积 (VThf) 变化,气体交换,通风持续时间,支气管肺功能失调 (BPD),腹腔内出血 (IVH) 和死亡率.
主要成果:
- 包括来自6项研究的260名早产婴儿 (2项交叉研究,4项队列);5项研究具有相关的偏差风险.
- 由于研究异质性,元分析是不可行的.
- 随着静脉通风的HFOV可能会降低VThf变异性,低心脏率和高心脏率的发生率;对低血和通风持续时间的发现是混合的.
- 观察到类似的IVH,白血病和死亡率. 一项研究表明,没有BPD等级2-3的HFOV与VT的生存率有所改善.
结论:
- 在HFOV期间的体积定位可能会改善VThf的可变性,并减少异常的二氧化碳水平.
- 需要进行强大的随机对照试验,以最终比较HFOV与VT和传统HFOV之间的临床结果.
相关概念视频
Mechanical Ventilation II: Invasive Ventilation
84
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
84
Mechanical Ventilation III: Noninvasive Ventilation
68
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
68
Mechanical Ventilation I: Indication and Settings
134
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
134
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
243
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
243
Ventilatory Modes
48
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
48
Assessment of Ventilation II: Respiratory Depth and Rhythm
1.3K
Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
1.3K


