高频震荡通气联合牛肺表面活性剂治疗新生儿急性呼吸窘迫综合征的临床效果

doi:10.20047/j.issn1673-7210.2022.26.23

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Abstract Objective To investigate the clinical effect of high frequency oscillatory ventilation (HFOV) combined with calf pulmonary surfactant in the treatment of neonatal acute respiratory distress syndrome (ARDS). Methods From January 2018 to June 2021, 80 cases of neonatal ARDS who received ventilator-assisted ventilation in Neonatal Intensive Care Unit of Fuyang Women’s and Children’s Hospital, Anhui Province were selected as the research subjects. They were divided into study group (48 cases, HFOV combined with calf pulmonary surfactant) and control group (32 cases, conventional mechanical ventilation combined with calf pulmonary surfactant) by coin toss method. The treatment effect (ventilator use time, oxygen days after weaning, and hospitalization days) were compared between the two groups; the improvement of blood gases (arterial partial pressure of oxygen [PaO2], arterial partial pressure of carbon dioxide [PaCO2], oxygenation index [OI], and respiratory index [RI]) during ventilation, ventilation lasted for 12, 24, 48, and 72 h were compared between two groups; the occurrence of complications was observed. Results The ventilator use time, oxygen days after weaning, and hospitalization days in study group were shorter than those in control group, and the differences were statistically significant (P < 0.05). Pairwise comparison of PaO2, PaCO2, OI, and RI at different time points between two groups showed statistical significance (P < 0.05). There were statistically significant differences in PaO2, PaCO2, OI, and RI between two groups at 12, 24 and 48 h after ventilation (P < 0.05). After 72 h ventilation, there were significant differences in OI and RI between two groups (P < 0.05). The complication rate of study group was lower than that of control group, and the difference was statistically significant (P < 0.05). Conclusion HFOV combined with calf pulmonary surfactant in the treatment of neonatal ARDS can significantly improve the blood oxygen status, shorten the mechanical ventilation and oxygen use time, and reduce the incidence of complications, which has good clinical efficacy.

Key words： Acute respiratory distress syndrome High frequency oscillatory ventilation Calf pulmonary surfactant Clinical efficacy Complication

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	LI Jie ZHANG Hehua LI Lei LI Shuai▲

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LI Jie ZHANG Hehua LI Lei LI Shuai▲. Clinical effect of high frequency oscillatory ventilation combined with calf pulmonary surfactant in the treatment of neonatal with acute respiratory distress syndrome[J]. 中国医药导报, 2022, 19(26): 103-106.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2022.26.23 OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I26/103

[1] 唐烁，包蕾.新生儿急性呼吸窘迫综合征临床特征与预后相关因素分析[J].第三军医大学学报，2019，41（9）：898-902.
[2] 张永芳，于新桥，廖建华，等.鄂西南地区新生儿急性呼吸窘迫综合征临床流行病学调查[J].中国当代儿科杂志，2020，22（9）：942-947.
[3] 迟明，梅亚波，封志纯.新生儿急性呼吸窘迫综合征研究进展[J].中国当代儿科杂志，2018，20（9）：724-728.
[4] Meyers M，Rodrigues N，Ari A. High-frequency oscillatory ventilation：A narrative review [J]. Can J Respir Ther，2019，55（2）：40-46.
[5] 常明，卢红艳，相虹，等.不同机械通气方式联合肺表面活性剂对新生儿急性呼吸窘迫综合征呼吸力学的影响[J].实用医学杂志，2017，33（6）：916-919.
[6] 常明，卢红艳，相虹，等.高频振荡通气联合肺表面活性剂对新生儿急性肺损伤呼吸力学的影响[J].广东医学，2016，37（23）：3540-3543.
[7] Fan E，Brodie D，Slutsky AS. Acute Respiratory Distress Syndrome：Advances in Diagnosis and Treatment [J]. JAMA，2018，319（7）：698-710.
[8] De Luca D，van Kaam AH，Tingay DG，et al. The Montreux definition of neonatal ARDS：biological and clinical background behind the description of a new entity [J]. Lancet Respir Med，2017，5（8）：657-666.
[9] Johnson AH，Peacock JL，Greenough A，et al. High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity [J]. N Engl J Med，2002，347（9）：633-642.
[10] Wong JJ，Liu S，Dang H，et al. The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome [J]. Crit Care，2020， 24（1）：31.
[11] Sánchez LM，González PN，Belik J，et al. New Ventilator Strategies：High-Frequency Oscillatory Ventilation Combined with Volume Guarantee [J]. Am J Perinatol，2018， 35（6）：545-548.
[12] Fielding SV，Matthay MA，Calfee CS. Beyond Low Tidal Volume Ventilation：Treatment Adjuncts for Severe Respiratory Failure in Acute Respiratory Distress Syndrome [J]. Crit Care Med，2018，46（11）：1820-1831.
[13] Cho YJ，Moon JY，Shin ES，et al. Clinical Practice Guideline of Acute Respiratory Distress Syndrome [J]. Tuberc Respir Dis（Seoul），2016，79（4）：214-233.
[14] Sud S，Sud M，Friedrich JO，et al. High-frequency oscillatory ventilation versus conventional ventilation for acute respiratory distress syndrome [J]. Cochrane Database Syst Rev，2016，4（4）：4085.
[15] 高晓燕，高倩，寇同欣，等.注射用牛肺表面活性剂预防新生儿呼吸窘迫综合征的Meta分析[J].中国新药杂志，2018，27（19）：2322-2331.
[16] 张靖，张焕新，王景.不同剂量牛肺表面活性剂联合经鼻间歇正压通气治疗新生儿呼吸窘迫综合征的临床观察[J].中国药房，2016，27（35）：4985-4987.
[17] 王晓芳，刘玲.无创高频机械通气对呼吸衰竭新生儿肺氧合能力、CO2潴留和酸中毒的影响[J].天津医药，2019， 47（11）：1161-1165.
[18] Chen L，Wang L，Ma J，et al. Nasal High-Frequency Oscillatory Ventilation in Preterm Infants With Respiratory Distress Syndrome and ARDS After Extubation：A Randomized Controlled Trial [J]. Chest，2019，155（4）：740-748.
[19] 何明嫄.新生儿高频振荡通气的撤机方式探讨[J].中国当代儿科杂志，2019，21（12）：1234-1239.
[20] Gaertner VD，Waldmann AD，Davis PG，et al. Transmission of Oscillatory Volumes into the Preterm Lung during Noninvasive High-Frequency Ventilation [J]. Am J Respir Crit Care Med，2021，203（8）：998-1005.
[21] DiBlasi RM，Crotwell DN，Shen S，et al. Iloprost drug delivery during infant conventional and high-frequency oscillatory ventilation [J]. Pulm Circ，2016，6（1）：63-69.
[22] 雷菊芳，肖晓林，万静.HFOV+PS、CMV+PS和CMV治疗新生儿ALI/ARDS的临床疗效比较[J].中国妇幼保健，2019，34（12）：2752-2756.
[23] 张霞，黄奕霖，玉会，等.高频振荡通气联合猪肺磷脂注射液治疗新生儿胎粪吸入综合征并肺动脉高压的临床效果[J].临床和实验医学杂志，2022，21（8）：874-878.
[24] Jain D，Bancalari E. New Developments in Respiratory Support for Preterm Infants [J]. Am J Perinatol，2019，36（S02）：S13-S17.
[25] Ning B，Liang L，Lyu Y，et al. The effect of high-frequency oscillatory ventilation or airway pressure release ventilation on children with acute respiratory distress syndrome as a rescue therapy [J]. Transl Pediatr，2020，9（3）：213-220.
[26] Sklar MC，Patel BK，Beitler JR，et al. Optimal Ventilator Strategies in Acute Respiratory Distress Syndrome [J]. Semin Respir Crit Care Med，2019，40（1）：81-93.