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首页> 外文期刊>Journal of paediatrics and child health >Respiratory support for children in the emergency department
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Respiratory support for children in the emergency department

机译：急诊科对儿童的呼吸支持

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Respiratory support in paediatric emergency settings ranges from oxygen delivery with subnasal oxygen to invasive mechanical ventilation. Recent data suggest that oxygen can cause reperfusion injuries and should be delivered with caution within well-defined clinical target ranges. Most mild to moderate respiratory distress conditions with an oxygen requirement may benefit from early use of continuous positive airway pressure. High-flow nasal cannula therapy (HFNC) is an emerging alternative way to support the inspiratory effort combined with oxygen delivery and positive expiratory pressures without the need of complicated equipment or good compliance from the child. Besides a positive pressure support effect, HFNC therapy reduces the physiological dead space with improved CO2 clearance. A decrease in heart and respiratory rate within the first few hours after initiation of HFNC therapy is likely to identify responders of the treatment. The use of non-invasive ventilation such as continuous positive airway pressure or the use of bi-level positive airway pressure ventilation in emergency departments has increased, and it has been recognised that continuous positive airway pressure support for older children with asthma is particularly efficient.
机译：小儿紧急情况下的呼吸支持范围从从鼻下供氧到有创机械通气。最近的数据表明，氧气会导致再灌注损伤，应在明确的临床目标范围内谨慎输送氧气。早期需要使用持续的气道正压通气，最轻度至中度的呼吸窘迫情况需要氧气。高流量鼻插管疗法（HFNC）是一种新兴的替代方法，可在不需要复杂设备或儿童良好依从性的情况下，结合吸氧和正向呼气压力来支持吸气努力。除了具有正压支持作用外，HFNC治疗还可以通过改善CO2清除率来减少生理死角。在开始HFNC治疗后的最初几个小时内，心脏和呼吸频率的降低很可能会确定治疗的反应者。在急诊室使用无创通气（例如持续的气道正压通气）或使用双水平气道正压通气的情况有所增加，并且已经认识到，持续气道正压持续支持对较大的哮喘儿童特别有效。

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