ABSTRACT
Objective To investigate the clinical effects of pulmonary surfactant ( PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal inter-mittent positive pressure ventilation(SNIPPV). Methods We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University. According to the different treatment,they were divided into PS+ cit-rate caffeine combination group and control group. The control group(53 neonates)was treated by PS alone. The combination group(46 neonates)was treated with PS combined with caffeine citrate. The indexes of vent-ilator time,the time of using oxygen,length of hospital stay and complications were compared between the two groups. Results The indexes of ventilator time,the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group. The differences were statistically significant(P<0. 05). However,the incidences of ventilator associated pneumonia,gastrointestinal dysfunc-tion,arrhythmia and other complications were not significantly different between the two groups(P>0. 05). Conclusion PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively im-prove the pulmonary function of infants. It could improve the neonatal survival rate and reduce complications. It is worth to be recommended.
ABSTRACT
En esta revisión se recogen los conceptos fundamentales del uso de la ventilación mecánica (VM) invasiva, principalmente en la insufciencia respiratoria aguda. La VM es una práctica común en la unidad de cuidados intensivos (UCI) y debe ser entendida como una terapia de sostén destinada a sustituir el trabajo respiratorio mientras se restablece el balance entre la demanda ventilatoria y la capacidad del paciente para sostenerla. Se debe reconocer que el objetivo de la VM no es la normalización de los gases sanguíneos, sino obtener un intercambio gaseoso razonable, sin sobrepasar los umbrales de seguridad, lo que permite limitar el daño inducido por su uso.
In this review, we collect the fundamental concepts of the use of invasive mechanical ventilation (MV) in children, particularly in acute respiratory failure. MV is a common practice in the ICU and must be understood as a therapeutic intervention to replace the work of breathing while restores the balance between ventilatory demand and the patient's ability to sustain it. It is essential for the clinician to recognize that the goal of mechanical ventilatory support is not to normalize the patient's blood gases but providing a reasonable gas exchange; the benefts are obtained if the safety thresholds are not exceeded. Thus, this strategy has become the only tool available to limit the development of ventilator-induced lung injury (VILI).