Clinical report of lung recruitment maneuver combined with low tidal volume in the treatment of twenty-two cases of neonatal acute lung injury

GAO Shu-qiang

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Clinical report of lung recruitment maneuver combined with low tidal volume in the treatment of twenty-two cases of neonatal acute lung injury

更新时间：2024-01-17

- Clinical report of lung recruitment maneuver combined with low tidal volume in the treatment of twenty-two cases of neonatal acute lung injury
- Journal of Chongqing Medical University Vol. 36, Issue 10, Pages: 1271-1273(2011)
- 作者机构：
  
  成都市妇女儿童中心医院新生儿科
- 作者简介：
- 基金信息：
- DOI：
  CLC： R722.1
- Published：2011，
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[1]高淑强.新生儿肺复张策略联合小潮气量通气治疗急性肺损伤22例报告[J].重庆医科大学学报,2011,36(10):1271-1273.

GAO Shu-qiang. Clinical report of lung recruitment maneuver combined with low tidal volume in the treatment of twenty-two cases of neonatal acute lung injury. [J]. Journal of Chongqing Medical University 36(10):1271-1273(2011)
[1]高淑强.新生儿肺复张策略联合小潮气量通气治疗急性肺损伤22例报告[J].重庆医科大学学报,2011,36(10):1271-1273. DOI：

GAO Shu-qiang. Clinical report of lung recruitment maneuver combined with low tidal volume in the treatment of twenty-two cases of neonatal acute lung injury. [J]. Journal of Chongqing Medical University 36(10):1271-1273(2011) DOI：

摘要

目的:观察采用肺复张策略（Lung recruitment maneuver

LRM）联合小潮气量机械通气治疗新生儿急性肺损伤（Acutelung injury

ALI）的临床有效性及安全性

探索在ALI新生儿中建立合理的机械通气模式的方法。方法:前瞻性观察我院新生儿重症监护室（Neonatal intensive care unit

NICU）收治的22例ALI患儿

诊断标准参照1994年欧美联席会议所制定

给予小潮气量联合复张策略（Recruitment maneuver

RM）的通气方式。实施RM时采用持续肺膨胀（Cst）法

每8 h进行1次

共3 d。分别在患儿第1次LRM之前和LRM之后的12、24、48、72 h记录RM后的血气指标、呼吸机参数及血流动力学指标

以及使用RM3

d后复查胸片

随访患儿的上机时间及预后。结果:治疗后12、24、48、72 h

RM组PaO2、PaO2/FiO2和Cst呈明显上升趋势

且均显著高于治疗前基础组以及同时间点非RM组值;同时

二氧化碳分压（Arterial carbon dioxide tension

PaCO2）和吸气峰压（Peak inspiratory pressure

PIP）则明显下降

均显著低于治疗前基础组以及同时间点非RM组值。RM组复张后各时间点的心率和血压同复张前无明显差异（P

0.05）。结论:LRM联合小潮气量机械通气可以改善ALI患儿的氧合功能并提高其肺顺应性。患儿的耐受性良好

具有临床可行性。

Abstract

Objective:To explore the effect and feasibility of recruitment maneuver(RM) combined with low tidal volume in neonatal acute lung injury.Methods:A prospective physiologic study was conducted in the neonatal intensive care unit(NICU).Twenty-two consecutive eligible neonatal patients with ALI according to the 1994 AECC definition were enrolled in this study.The children in RM group received the ventilation of RM with low tidal volume.The clinician administered RM was performed at 10 cm H2O continuous positive airway pressure(CPAP) for 30 seconds.RMs were conducted once every eight hours for three days.Data on gas exchange

lung mechanics and hemodynamics from pre-RM to post-RM(at 12

48 and 72 hours) were recorded.To monitor the pathogenic conditions of the children

the radiographic examination was repeated within 3-5 days after administration.Results:The values of PaO2

PaO2/FiO2 and Cst in RM group significantly increased compared with baseline data and the values in non-RM group at 12

48 and 72 hours after RM was administrated(P<0.05).However

the values of PaCO2 and PIP markedly decreased compared baseline and non-RM group at the same time point(P<0.05).No significant difference of heart rate and blood pressure was found between before and after RM was administered in RM group(P>0.05).Conclusion:RM can significantly improve the oxygenation and attenuate the deterioration of pulmonary function in the treatment for neonatal ALI

and can safely and feasibly improve the lung compliance.

关键词

急性肺损伤新生儿肺复张策略机械通气

Keywords

acute lung injuryneonatelung recruitment maneuvermechanical ventilation

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Related Institution

Department of Respiratory Medicine,Cangzhou People's Hospital

Department of Critical Care Medicine,General Hospital of Ningxia Medical University

Department of Neonatology, Children's Hospital of Chongqing Medical University; National Clinical Research Center For Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatrics

Neonatal Diagnosis and Treatment Center,the Children’s Hospital,Chongqing Medical University

Department of Neonatology,the Children’s Hospital,Chongqing Medical University

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