无创通气在早产儿呼吸窘迫综合征中的应用进展

Current application of noninvasive ventilation in preterm infants with respiratory distress syndrome

摘要:

为了减少有创通气所带来的严重并发症,临床医生越来越多地在早产儿呼吸窘迫综合征(RDS)的初始治疗中采用无创通气(NIV)技术.在过去的40 年中,经鼻持续气道正压通气(NCPAP)一直是治疗RDS 的主要模式,甚至是唯一的NIV 模式.近十年来,随着传感器和人机连接界面的改进,产生了不少新的NIV 模式,如经鼻间歇正压通气(NIPPV)、双水平气道正压通气(BiPAP)等.随后的研究表明,有些新的模式在RDS 的治疗上可能较NCPAP 更为优越.为了让临床医生了解NIV 在早产儿RDS 初始治疗中应用的新进展,更好的运用NIV 技术,该文复习了近年来相关文献并作简要综述.

Abstract:

In order to reduce the serious complications associated with invasive mechanical ventilation, noninvasi veventilation (NIV) has increasingly been chosen as the primary ventilation in preterm infants with respiratorydistress syndrome (RDS). In the last 4 decades, nasal continuous positive airway pressure (NCPAP) has been as a main,or even the only mode of NIV in preterm infants with RDS. In the recent decade, improvements in sensors and nasalairway interfaces have resulted in the introduction of a variety of other new types of NIV, such as nasal intermittent positive pressure ventilation (NIPPV), bi-level positive airway pressure (BiPAP). Subsequent studies have shown thatsome new modes may be more superior to NCPAP in preterm infants with RDS. In order to further understand theapplication of various NIV modes, we review literatures about all kinds of NIV as a primary mode of ventilation inpreterm infants with RDS.