儿童无创通气的局限性及气管插管介入时机选择

近年来,无创通气在儿童呼吸支持领域有了较快发展。无创通气无需气管插管,操作简便,对部分呼吸道疾病有较为满意的疗效。但是,无创通气不能完全替代有创机械通气。在有些疾病无创通气不仅有着较高的失败率,而且会因气管插管的延误导致病情恶化,增加患儿的病死率。在行无创通气之前需评估患儿是否适宜进行无创通气治疗。对于进行无创通气治疗的患儿需严密监护,动态观察生理指标和监测数据的变化,掌握好气管插管的时机,以免造成有创机械通气治疗的延误。

Deficiency of noninvasive ventilation and timing of endotracheal intubation in children

In recent years,noninvasive ventilation has developed rapidly in the field of respiratory support in children.Noninvasive ventilation does not need endotracheal intubation. It is easy to operate and has satisfactory curative effect on some serious respiratory diseases. However,noninvasive ventilation cannot replace invasive ventilation completely. In some cases,noninvasive ventilation has a high failure rate,and the delay of endotracheal intubation can lead to the deterioration of the disease and increase the mortality of children. Pediatricians need to evaluate whether the patient is suitable for NIV treatment.For children treated with NIV,close monitoring is needed to observe the changes in physiological indexes and monitoring data,and the timing of endotracheal intubation must be suitable,so as to avoid the delay of IMV treatment.