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Predicting effectiveness of high frequency ventilation in neonates with severe respiratory failure
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1671-0282.2004.06.004
- Key Word:
- 高频通气;重症呼吸衰竭;婴儿;新生儿
Abstract： 目的探讨早期预测高频通气(high frequency ventilation,HFV)疗效指标.方法对传统通气治疗效果欠佳改用HFV的重症呼吸衰竭新生儿,以HFV治疗24 h时吸入氧浓度(FiO2)下降程度(降至≤0.5或下降幅度≥30%)为依据,将患儿分为A组和B组,比较两组在HFV治疗前2 h、和治疗后1、6、12、24 h动脉/肺泡氧分压比率(a/A)及氧合指数(OI).结果全组共50例,平均孕周(35.6±4.1)周,平均出生体重(2.35±0.89)kg,入院日龄1～490 h(M=5 h).全组病例60%存活.组1 37例,a/A在治疗后1 h即升高(P＜0,05),在24h内各观察时段上升速率约为25%,OI治疗后6 h明显下降(P＜O.05),幅度约25%,此后持续下降.其中34例撤机成功;组2 13例,a/A和OI在观察期间呈波动变化,各时段与治疗前比较无显著差异(P＞0.05),全组均未能撤机并死亡.结论HFV治疗后6 h a/A较治疗前升高约50%,OI降低25%,因此a/A、OI可作为早期,预示HFV治疗有效的指标.
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