儿童无创通气的发展历程及其局限性

The development process and limitations of non-invasive ventilation in children

无创通气(NIV)的发展历程已近百年,折射了现代医学发展史。目前NIV在儿科有着广泛应用,是呼吸支持治疗的重要组成部分,也是治疗儿童急性呼吸衰竭的重要方法。但是NIV因其自身特点,存在应用的限制和禁忌证,无法替代有创机械通气。使用NIV前需仔细评估患儿病情。NIV在儿童急性呼吸窘迫综合征、免疫功能受损和气管插管拔管后治疗时存在失败可能,可导致不良预后。NIV疗效不佳、病情恶化时需迅速进行气管插管和有创机械通气治疗。应该加强医务人员对NIV使用的培训,有经验的团队和精细化管理是NIV安全和有效使用的重要保证。

The development process of non-invasive ventilation(NIV)has been nearly a century,reflecting the history of modern medical development.At present,NIV is widely used in pediatrics,and which is an important component of respiratory support therapy,as well as an important method for treating acute respiratory failure in children.However,non-invasive ventilation,due to its own characteristics,has limitations and contraindications,and cannot replace invasive mechanical ventilation.Before using NIV,it is necessary to carefully evaluate the patient's condition.NIV may fail in the treatment of pediatric patients with acute respiratory distress syndrome,immune dysfunction and post-extubation with acute respiratory failure,leading to poor prognosis.When the efficacy of NIV is poor and the condition worsens,prompt tracheal intubation and invasive mechanical ventilation treatment should be performed.Medical personnel should strengthen their training on the use of NIV.Teams with experienced members and refined management are important guarantees for the safe and effective use of NIV.