新生儿无创正压通气的应用进展

Application progress of noninvasive positive pressure ventilation in newborns

无创正压通气指的是不经过人工气道(气管切开或气管插管),而是通过鼻罩、鼻塞或面罩等无创伤的方式将患者和呼吸机相连接,经呼吸机给予压力支持而完成通气的方式,临床主要应用于早产儿呼吸暂停、气管插管拔管后及急性呼吸窘迫综合征初始治疗等。目前临床常用的无创正压通气包括经鼻持续气道正压通气、经鼻间歇正压通气/经鼻同步间歇正压通气、双水平气道正压通气、加温湿化高流量鼻导管通气和经鼻高频通气等。近年来,无创通气技术得到快速发展,在新生儿,尤其是早产儿呼吸支持措施中,常被优先考虑,旨在减少有创通气带来的相关损伤及并发症,改善患儿预后。因此,加强对无创通气的理解及认识很有意义,本文就以上几种常用无创正压通气的应用进展作一综述。

Noninvasive positive pressure ventilation refers to non artificial airway(tracheotomy or endotracheal intubation),but a non-invasive way to connect patients with ventilator through nasal mask,nasal obstruction or mask,and complete ventilation by giving pressure support through ventilator.Clinically,it is mainly used in apnea of preterm infants,extubation after endotracheal intubation and initial treatment of acute respiratory distress syndrome.At present,noninvasive positive pressure ventilation commonly used in clinic includes nasal continuous positive airway pressure,nasal intermittent positive pressure ventilation/nasal synchronized intermittent positive pressure ventilation,bi-level positive airway pressure,heated humidified high-flow nasal cannula and nasal high frequency oscillatory ventilation,etc.In recent years,noninvasive ventilation technology has developed rapidly.It is often given priority in respiratory support measures for newborns,especially preterm infants,in order to reduce the related injuries and complications caused by invasive ventilation and improve the prognosis of children.Therefore,it is of great significance to strengthen the understanding and recognization of noninvasive ventilation.This paper summarizes the application progress of the above common noninvasive positive pressure ventilation.