无创高频振荡通气在早产儿呼吸支持中的临床应用

doi:10.12372/jcp.2023.23e0789

摘要/Abstract

摘要：

无创高频振荡通气（noninvasive high-frequency oscillatory ventilation， NHFOV）是通过持续气流产生气道压力并在自主呼吸上叠加一定频率振荡的新型无创通气模式。NHFOV结合了高频通气的不需要同步、高效清除二氧化碳和经鼻持续气道正压通气（nasal continuous positive airway pressure，NCPAP）的无创接口、增加功能残气量改善氧合两者的优点。作为突破无创通气瓶颈的新模式，NHFOV在早产儿呼吸支持的临床应用逐渐增加。目前NHFOV应用没有统一的规范标准，取决于当地新生儿重症监护病房（neonatal intensive care unit，NICU）的惯例和方便。文章对NHFOV作用机制、适应证、呼吸机设备、无创接口、参数设置以及临床循证医学证据进行总结。

关键词: 无创高频振荡通气, 无创呼吸支持, 临床证据, 早产儿

Abstract:

Noninvasive high-frequency oscillatory ventilation(NHFOV) is based on the application of a continuous flow, generating a constant distending positive pressure with superimposed oscillations, delivered all over the spontaneous breathing cycle. NHFOV matches together the advantages of high-frequency ventilation (no need for synchronisation, high efficacy in removing CO₂) and nasal continuous positive airway pressure (NCPAP, non-invasive interface, increase in functional residual capacity allowing oxygenation to improve). As it represents another “brick in the wall” of the non-invasive respiratory support, it has been increasing applied in neonatal intensive care unit (NICU). At present, there is no consensus guidelines on the application of NHFOV, the application of NHFOV is largely based on the local practices and comfort. This article summarizes the physiology of NHFOV, indications, ventilator device, interfaces, parameter settings, and clinical evidence based on a PubMed literature search.

Key words: non-invasive high-frequency oscillatory ventilation, non-invasive respiratory support, clinical evidence, preterm infant

朱兴旺, 史源. 无创高频振荡通气在早产儿呼吸支持中的临床应用[J]. 临床儿科杂志, 2023, 41(10): 641-645.

ZHU Xingwang, SHI Yuan. Clinical application of non-invasive high-frequency oscillatory ventilation in premature infants[J]. Journal of Clinical Pediatrics, 2023, 41(10): 641-645.

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