Clinical study of high-frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of neonatal acute respiratory distress syndrome complicated with pneumothorax
Objective To explore the clinical efficacy and safety of high frequency oscillatory ventilation(HFOV)combined with pulmonary surfactant(PS)in the treatment of newborns with acute respiratory distress syndrome(ARDS)and pneumothorax.Methods Clinical data of 205 newborns with ARDS and pneumothorax were retrospectively collected.The study subjects were randomly divided into three groups according to treatment methods:105 cases in the HFOV+PS group,50 cases in the HFOV group,and 50 cases in the conventional mechanical ventilation(CMV)+PS group.Those in the HFOV+PS group were managed by tracheal intubation,HFOV and slow tracheal injection of PS suspension.Newborns in the HFOV group were treated with tracheal intubation and HFOV.Newborns in the CMV+PS group received tracheal intubation,CMV and slow tracheal injection of PS suspension.Arterial blood gas,lung function indicators,and the ventilation and oxygenation time before and after mechanical ventilation were compared.Results There were no significant differences in the pH level,partial pressure of oxygen(PaO2),and partial pressure of carbon dioxide(PaCO2)at 72h among the three groups(P＞0.05).Newborns in the HFOV+PS group had significantly lower oxygenation index(OI)and resistance index(RI),and significantly higher PaO2/fraction of inspired oxygen(FiO2)than those of HFOV group and CMV+PS group,(P＜0.05).Ventilation and oxygenation periods were significantly shorter in the HFOV+PS group than HFOV and CMV+PS groups,which were significantly shorter in the HFOV group than CMV+PS group(P＜0.05).Ventilation time and oxygen consumption time of tracheal intubation ventilator were superior in the HFOV+PS group than HFOV and CMV+PS groups(P＜0.05).Conclusion HFOV+PS effectively treats neonatal ARDS and pneumothorax,which improves lung function,recovery of pneumothorax,and survival rate with good clinical outcomes.
万方数据
维普
