UNASSIGNED: We conducted a retrospective analysis of clinical data from 17 neonates who received ECMO support in our institution, divided into two groups based on ventilation strategy: ECMO with PPV (ECMO-PPV, n=8) and ECMO with supine positioning ventilation (ECMO-SPV, n=9). Parameters such as the P/F ratio [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2)], oxygenation index (OI), respiratory system compliance (Crs), and airway resistance (RAW) were collected and analyzed at baseline, and at 1, 2, and 3 days post-ECMO initiation. In the ECMO-PPV group, these parameters were also assessed 3 days pre-treatment and 2 hours post-treatment initiation.
UNASSIGNED: Initial comparisons between ECMO-PPV and ECMO-SPV groups showed no significant difference in PaO2/FiO2, OI, Crs, or RAW. Throughout the ECMO treatment, both groups demonstrated gradual improvements in PaO2/FiO2 and Crs, and reductions in OI and RAW. Notably, by day 3, the ECMO-PPV group exhibited significant improvements in Crs and RAW compared to the ECMO-SPV group (P<0.05). Specifically, in the ECMO-PPV group, Crs significantly increased and RAW decreased after 2 hours of initiating PPV, with these changes becoming statistically significant by day 3 (Crs P=0.03, RAW P=0.03). No severe PPV-related complications were noted.
UNASSIGNED: PPV during neonatal ECMO may improve respiratory compliance and reduce RAW, potentially aiding lung recovery. Our findings suggest PPV as a viable strategy for neonates under ECMO support.
■我们对在我们机构接受ECMO支持的17例新生儿的临床数据进行了回顾性分析,根据通气策略分为两组:ECMO+PPV(ECMO-PPV,n=8)和仰卧位通气的ECMO(ECMO-SPV,n=9)。P/F比[动脉氧分压(PaO2)/吸入氧气分数(FiO2)]等参数,氧合指数(OI),呼吸系统顺应性(Crs),收集并分析基线时的气道阻力(RAW),以及ECMO启动后1、2和3天。在ECMO-PPV组中,这些参数也在治疗前3天和治疗开始后2小时进行了评估.
■ECMO-PPV和ECMO-SPV组之间的初步比较显示PaO2/FiO2,OI,Crs,或RAW。在整个ECMO治疗过程中,两组均显示PaO2/FiO2和Crs逐渐改善,以及OI和RAW的减少。值得注意的是,到第3天,与ECMO-SPV组相比,ECMO-PPV组的Crs和RAW显着改善(P<0.05)。具体来说,在ECMO-PPV组中,开始PPV2小时后,Crs显着增加,RAW降低,这些变化在第3天变得具有统计学意义(CrsP=0.03,RAWP=0.03)。未发现严重的PPV相关并发症。
■新生儿ECMO期间的PPV可以改善呼吸顺应性并降低RAW,有可能帮助肺部恢复.我们的发现表明PPV是ECMO支持下新生儿的可行策略。