米力农辅助肺通气治疗新生儿持续肺动脉高压的效果及对患儿PASP、血清TIMP-1和MMP-2水平的影响

目的探究米力农辅助肺通气治疗新生儿持续肺动脉高压(PPHN)的疗效及对患儿肺动脉收缩压(PASP)、血清基质金属蛋白酶抑制因子-1(TIMP-1)和基质金属蛋白酶-2(MMP-2)水平的影响。方法按照入院顺序将2017年3月至2018年3月黄石市中心医院收治的96例PPHN患儿随机分为实验组和对照组,每组48例,分别给予米力农辅助肺通气疗法及单用肺通气疗法。治疗3d后,比较两组患儿治疗总有效率;记录其治疗前及治疗3d后心功能指标[PASP、体循环收缩压(SBP)]、血气分析指标[二氧化碳分压(PaCO2)、血氧张力(PaO2)、氧饱和度(SaO2)、酸碱度(PH)]、血清生化指标[TIMP-1、MMP-2]水平变化情况。结果治疗3d后,实验组患者治疗总有效率高于对照组(P<0.05);两组患儿PASP均低于治疗前(P均<0.05),SBP均高于治疗前(P均<0.05),且实验组患儿两项指标变化幅度均大于对照组(P均<0.05);两组患儿PaCO2均低于治疗前(P均<0.05),PaO2、SaO2、PH均高于治疗前(P均<0.05),且实验组患儿以上指标变化幅度均大于对照组(P均<0.05);两组患儿血清TIMP-1、MMP-2水平均较治疗前降低(P均<0.05),且实验组患儿降幅更大(P均<0.05)。结论米力农辅助肺通气治疗PPHN疗效确切,可有效降低患儿PASP,改善其心肺功能。

Proportional assist ventilation: methodology and therapeutics on COPD patients compared with pressure support ventilation

OBJECTIVE: To investigate the impact of proportional assist ventilation (PAV) on tolerance and breathlessness in ventilated chronic obstructive pulmonary disease (COPD), and to describe the patient-ventilator interaction, hemodynamic state, breathing pattern and work of breath during PAV and pressure support ventilation (PSV). METHODS: Ten intubated COPD patients on weaning from mechanical ventilation were studied. Elastance and resistance were measured by both the inspiratory-hold technique during a brief period of volume control ventilation and runaway technique during PAV. Each assistance level of PAV (80%, 60% and 40%) and PSV was selected randomly. Patients' response, hemodynamics, blood gas and lung mechanics were monitored. RESULTS: Tidal volume and respiratory rate didn't change in a consistent manner as the level of assist was decreased (P > 0.05). With the level of assist increasing, peak inspiratory pressure was increasing significantly (P