新生儿高频振荡通气中的容量保证

Volume-guaranteed of high-frequency oscillatory ventilation in newborn infants

由于呼吸机导致的肺损伤大多与潮气量过大有关,故主张高频振荡通气(HFOV)作为早产儿有创呼吸支持的一种可供选择的方法,以防止呼吸机相关肺损伤。在HFOV期间,由于肺机械力学的改变及人-机相互作用,同样的压力幅度和频率可能导致不同的胸腔振动和潮气量,而HFOV时叠加容量保证(VG)能减少高频气量波动和动脉血二氧化碳分压[pa(CO2)]的反复变化。临床前期新生动物研究和HFOV-VG在临床的应用已表明,高频率结合持续恒定的非常小的潮气量通气技术可降低呼吸机相关肺损伤的风险。

As lung damage caused by the ventilator is mostly related to the large tidal volume generated,high-frequency oscillatory ventilation(HFOV)has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator-induced lung injury.During HFOV,the same pressure amplitude and frequency can result in different chest oscillations and tidal volume due to changes in lung mechanics and patient-ventilator interactions.Using HFOV-volume guarantee(VG)can reduce fluctuations of high-frequency tidal volume(VThf)and the variability of partial pressure of carbon dioxide[pa(CO2)].Data from preclinical,neonatal animal studies and clinical use of HFOV-VG in newborn infants have demonstrated that high frequency and constant extremely low VThf can possibly decrease the risk of ventilator-associated lung trauma.