触发同步通气与传统通气治疗新生儿呼吸衰竭的比较

Compare SIMV with IMV in the treatment of neonatal respiratory failure

目的 探讨触发同步间歇指令通气 (SIMV)在新生儿机械通气中的临床应用价值。 方法 2 7例因肺部疾病需用机械通气的新生儿 ,15例用间歇指令通气 (IMV) ,12例用SIMV。两组出生体重、入院日龄无差异 ,原发病相似。将两组患儿用机时的FiO2 、MAP、和用机后 1、2、6、12、2 4h作组内比较 ,并比较两组患儿机械通气中用镇静剂的次数。 结果 SIMV组用机后 1hFiO2 显著下降 (P <0 0 2 ) ;用机后 2hMAP也显著下降 (P <0 0 5 ) ,IMV组在用机后 12hFiO2 才显著下降 (P <0 0 5 ) ;而MAP至2 4h仍无显著变化 (P >0 0 5 )。用呼吸机 3d内SIMV组用镇静剂的次数比IMV组明显减少 (2 2± 1 4次 /人和 7 6± 4 7次 /人 ,P <0 0 5 )。 结论 因肺部疾病需用机械通气的新生儿 ,SIMV方式较IMV方式能更快地降低FiO2 和MAP ,维持氧和 。

Objective To evaluate the clinical effect of synchronized intermittent mandatory ventilation(SIMV) in ventilated neonates.Methods Twenty seven neonates were studied.Fifteen of them used intermittent mandatory ventilation(IMV) and twelve with SIMV.The birth weight,the administration age were no difference between two groups,and the primary diseases were also similar.The starting parameters of FiO\-2,MAP,were compared with the parameters 1,2,6,12 and 24 hours after ventilation.The frequencys of sedatives used during the first three days of ventilation were also compared between two groups.Results In SIMV groups,FiO\-2 can be decreased obviously after 1 hour ventilation( P <0 02),MAP reduced after 2 hours( P <0 05).In IMV group,FiO\-2 decreased after 12 hours( P <0 05),MAP couldn′t reduced obviously within 24 hours( P <0 05).The times of sedatives used in SIMV group were more less than in IMV groups ( P <0 05).Conclusion In ventilated neonates,SIMV might be used with more rapidly reduced FiO\-2,MAP than IMV while maintaining oxygenation.And the sedatives used in SIMV were also obviously reduced.