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呼吸机是新生儿重症监护病房的主要仪器之一,适宜的机械通气对抢救危重患儿的生命至关重要。由于新生儿的呼吸生理及解剖特点与儿童和成人有明显不同,对呼吸机具有特殊要求。呼吸机的控制方式包括压力限定、容量限定、流速限定和时间限定等类型,常用的常频通气方式包括间歇正压通气、间歇正负压通气、持续正压呼吸道通气、间歇指令性通气、同步间歇指令性通气、分钟指令性通气和双水平呼吸道正压通气等。近年来在新型呼吸机上开发了一些新的通气方式,如压力调节容量控制通气、比例辅助性通气、压力支持及高频振荡通气等。现在介绍新生儿呼吸机控制及通气方式的基础上,对临床常用新生儿呼吸机的性能作一比较,以便临床选择。
Ventilator is one of the main instruments in neonatal intensive care unit. Appropriate mechanical ventilation is crucial for saving the lives of critically ill children. Due to the respiratory physiology and anatomical features of newborns are significantly different from those of children and adults, there are special requirements for ventilators. Ventilator control methods include pressure limit, capacity limit, flow rate limit and time limit and other types of common frequency ventilation including intermittent positive pressure ventilation, intermittent positive and negative pressure ventilation, continuous positive airway pressure ventilation, intermittent mandatory ventilation, synchronization Intermittent mandatory ventilation, minute mandatory ventilation and two-level positive airway pressure ventilation. In recent years, a number of new ventilation methods have been developed on new ventilators, such as pressure-controlled volume controlled ventilation, proportional assisted ventilation, pressure support and high-frequency oscillatory ventilation. Now introduce neonatal ventilator control and ventilation based on the performance of the commonly used neonatal ventilator to make a comparison for clinical choice.