新生儿肺动脉高压管理.pptVIP

新生儿肺动脉高压治疗;纲要;PPHN:流行病学 ;胎儿循环;宫外循环过渡;In PPHN;PPHN分类与病因;PPHN危险因素;Lakshminrusimha et al. J Appl Physiol. 2011; 111 :1441;;胎粪吸入综合症(MAS);MAS危险因素;抽吸预防MAS;鼻咽部抽吸;Halliday Sweet. Cochrane 2001 1; CD000500. ;PPHN 临床表现;PPHN 诊断;PPHN 的治疗;初始治疗;继续治疗;;计算氧合指数;强心药的应用;PPHN: 治疗选择;机械通气;高频通气;酸中毒加重缺氧肺血管收缩;多中心应用过渡通气及碱性治疗的差异;Walsh-Sukys M C et al. Pediatrics 2000;105:14-20;皮质激素的应用;表面活性物质的应用;Should we give Surfactant (mainly for MAS)?;血管扩张剂 for PPHN;Nitric Oxide- an endogenously produced gas- a treatment for PPHN;一氧化氮;Delivery of NO;昔多芬 for PPHN;体外膜肺氧合法（人工肺）;Variable Odds of neonatal death Odds ratio 95% confidence interval P value Gestational age 37 wk 1.7 1.2–2.5 0.01 pH?≤?7.20 1.5 1.1–2.1 0.02 SaO2 ≤ 65% 1.5 1.1–2.1 0.01 ECMO initiated?≥?DOL 5 1.8 1.2–2.6 0.01 Duration of ECMO ≥ 7 d 3.4 2.5–4.7 0.01 ;UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation: follow-up to age 4 years. Bennett CC et al. Lancet. 2001;357:1094.;ECMO for PPHN:并发症;不同治疗方法的治疗结果;总结