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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Childhood outcome after early high-frequency oscillatory ventilation for neonatal respiratory distress syndrome.
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Childhood outcome after early high-frequency oscillatory ventilation for neonatal respiratory distress syndrome.

机译：早期高频振荡通气治疗新生儿呼吸窘迫综合征后的童年结局。

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OBJECTIVE: In a previous multicenter controlled clinical trial, we randomly assigned surfactant-treated premature newborns with moderate to severe respiratory distress syndrome to early treatment with high-frequency oscillatory ventilation (HFOV) or to conventional ventilation (CV). Compared with control infants who were treated with CV, neonates who were treated with HFOV using a strategy designed to recruit and maintain lung volume and minimize oxygen exposure had clinical evidence of improved pulmonary outcome and less lung injury. We report a follow-up study designed to determine whether clinical differences persisted between these study groups. METHODS: Patients were recruited from 81 survivors at 1 center (Provo, Utah) and evaluated for sociodemographic and health history, growth, mental development, motor proficiency, and pulmonary function. RESULTS: Eighty-seven percent of the cohort who originally were assigned to treatment with HFOV (n = 36) or CV (n = 33) were seen in follow-up at a mean age of 77 months (6.4 years). There were no differences in the frequency of hospitalization, pulmonary illness, asthma, or disabilities. Growth, verbal IQ, and motor development were appropriate for age and not different between groups. Patients who initially were randomized to treatment with CV showed pulmonary function evidence of decreased peak expiratory flow, increased residual lung volume, and maldistribution of ventilation. CONCLUSION: Neurodevelopmental childhood outcome after early intervention HFOV was normal and not different compared with patients who were treated with CV. Surfactant replacement combined with early HFOV using a lung recruitment strategy ameliorates the acute lung injury in respiratory distress syndrome that predisposes some preterm infants to develop chronic lung disease.
机译：目的：在先前的一项多中心对照临床试验中，我们随机分配了经表面活性剂治疗的中度至重度呼吸窘迫综合征早产儿，以高频振荡通气（HFOV）或常规通气（CV）进行早期治疗。与接受CV治疗的对照婴儿相比，使用旨在募集和维持肺活量并最大程度减少氧气暴露的策略接受HFOV治疗的新生儿具有改善肺结局和减少肺损伤的临床证据。我们报告了一项旨在确定这些研究组之间是否存在临床差异的后续研究。方法：从1个中心（犹他州普罗沃）的81名幸存者中招募患者，并对其社会人口统计学和健康史，生长，智力发育，运动能力和肺功能进行评估。结果：在最初接受HFOV（n = 36）或CV（n = 33）治疗的队列中，有87％接受了随访，平均年龄为77个月（6.4岁）。住院，肺部疾病，哮喘或残疾的频率没有差异。生长，言语智商和运动发育适合年龄，两组之间没有区别。最初被随机分组​​接受CV治疗的患者显示出肺功能的证据，即呼气峰值流量减少，残余肺量增加和通气分配不均。结论早期干预后HFOV的神经发育儿童预后正常，与接受CV治疗的患者相比无差异。使用肺募集策略替代表面活性剂并结合早期HFOV可改善呼吸窘迫综合征中的急性肺损伤，这使一些早产儿容易患上慢性肺病。

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