无创通气在治疗新生儿呼吸系统疾病中的应用进展

Progress in non-invasive ventilation for the treatment of neonatal respiratory disease

新生儿的机械通气分为有创机械通气及无创机械通气。为了减少有创通气的肺损伤,目前临床越来越多应用无创通气模式。经鼻间歇正压通气(NIPPV)的早期应用已经成为目前很多新生儿重症监护病房(NICU)的主要无创通气模式,同时早期联合选择性应用肺表面活性物质可以减少慢性肺疾患的发生。文章讨论无创呼吸支持模式的使用,包括持续气道正压通气(CPAP);双水平CPAP模式,例如SiPAP及NIPPV;以及处于研究阶段的同步经鼻间歇正压通气、神经调节辅助通气,无创高频振荡通气等无创通气模式的应用现状及前景。

Mechanicalventilation in newborns can be divided into invasive mechanical ventilation and non-invasive me-chanical ventilation. In order to reduce invasive ventilation-induced lung injury, more and more non-invasive ventilation patterns have been used clinically. Early application of nasal intermittent positive pressure ventilation （NIPPV） has become the main mode of non-invasive ventilation in many neonatal intensive care units （NICU）. At the same time, the combination with selective pulmonary surfactant can reduce the incidence of chronic lung disease. This article reviews the use and prospect of non-invasive respiratory support modes which include continuous positive airway pressure （CPAP） and bi-level CPAP mode （BiPAP） such as SiPAP and NIPPV. Some modes which are in the research stage were also reviewed including synchronized nasal intermittent positive pressure ventilation, neurally adjusted ventilatory assist and non-invasive high-frequency oscillatory ventilation.