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成比例辅助通气在呼吸机依赖极低出生体重儿中的临床应用

段江 何玺玉 郑天 孔祥永 封志纯

中国当代儿科杂志2012,Vol.14Issue(6):401-405,5.
中国当代儿科杂志2012,Vol.14Issue(6):401-405,5.

成比例辅助通气在呼吸机依赖极低出生体重儿中的临床应用

Clinical application of proportional assist ventilation in very low birth weight infants with ventilator dependence

段江 1何玺玉 1郑天 1孔祥永 1封志纯1

作者信息

  • 1. 北京军区总医院附属八一儿童医院,北京100700
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摘要

Abstract

Objective To study the effect of proportional assist ventilation ( PAV) on physiology and respiratory mechanics in very low birth weight ( VLBW) infants with ventilator dependence by comparison with conventional assist/ control (A/C) ventilation. Methods Forty-six infants with ventilator dependence were randomly divided into two groups according to the ventilation model: PAV (n = 23) and A/C (n = 23). The gain of resistive and elastic unloading was set based on the runway method in the PAV group. Ventilation parameters were sel based on the conventional method in the A/C group. Infants were observed for 30 minutes three times per day for three consecutive days. Arterial gas analysis results, transcutaneous saturation of oxygen ( SPO2 ) , heart rate, blood pressure ( BP) , respiratory rate ( RR) , mean airway pressure (MAP), peak inspiratory pressure (PIP), tide volume (VT), minute volume ( MV) and oxygenation index(01), were compared between the two groups. Results Compared with the A/C group, PaO2 and 01 in the PAV group were significantly higher while PIP and MAP were significantly lower. There were no significant differences in FiO2, SPO2, pH, PaCO2, PEEP, VT, MV and RR between the two groups. Although mean arterial blood pressure and heart rate in the PAV group were not different from the A/C group, beat-to-beat variabilities in systolic and diastolic arterial blood pressure were significantly lower in the PAV group than in the A/C group. Conclusions PAV may safely maintain gas exchange at lower airway pressures compared with A/C ventilation in VLBW infants. It can also improve oxygenation and infant-ventilator synchronization.

关键词

成比例辅助通气/传统辅/控通气/极低出生体重儿

Key words

Proportional assist ventilation/ Conventional assist/control ventilation/ Very low birth weight infant

分类

医药卫生

引用本文复制引用

段江,何玺玉,郑天,孔祥永,封志纯..成比例辅助通气在呼吸机依赖极低出生体重儿中的临床应用[J].中国当代儿科杂志,2012,14(6):401-405,5.

中国当代儿科杂志

OA北大核心CSCDCSTPCDMEDLINE

1008-8830

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