ABSTRACT
Se presenta el caso de un recién nacido que sufrió aspiración masiva de meconio e hipertensión pulmonar, fue tratado durante varios días con ventilación mecánica convencional además de medidas complementarias sin conseguir mejoría hasta que se utilizó ventilación de alta frecuencia.
We present a case of a newborn with massive meconium aspiration syndrome and pulmonary hypertension; the patient was treated with conventional mechanical ventilation plus supportive therapy without obtaining any results, until he was changed to high frequency ventilator obtaining a satisfactory outcome.
ABSTRACT
PURPOSE: Flow interruptor high frequency ventilator(HFV) on neonatal respiratory failure caused by various disorders has been applied in order to assess its therapeutic effect and safety. METHODS: Premature babies below 1.8kg with respiratory failure from 1991 to 1997 in the Fatima neonatal intensive care unit(NICU) for 6 year and 4 months are included. Flow interruptor HFV with low intermittent mandatory ventilation(IMV) has been applied in 74 cases. If clinical symptom and arterial blood gas analysis(ABGA) became stable for 6-12 hrs, we started weaning aggressively. RESULTS: Mean duration of HFV with low IMV was 5.4 4 days. Initial success rate of weaning was 63 cases(85.1%). Weaning failure rate was 11 cases(14.9%). Six cases was due to underlying sepsis. Four cases was caused by pneumothorax and one case resulted from patent ductus arteriosus(PDA) with congestive heart failure(CHF). Complication of HFV with combined low IMV was 5 cases of pneumothorax, 4 cases of grade III intraventricular hemorrhage and one case of bronchopulmonary dysplasia(BPD). Eleven cases of stage III or more retinopathy of prematurity(ROP) and 5 cases of periventricular leukomalasia(PVL) were confirmed. CONCLUSION: Flow interruptor HFV with low IMV can be used safely as conventional mechanical ventilators in the case of respiratory failure caused by various disorders. If MAP has been adjusted appropriately, incidence of pneumothorax and BPD are expected to diminish by aggressive weaning as clinical symptom become stable.
Subject(s)
Infant, Newborn , Estrogens, Conjugated (USP) , Heart , Hemorrhage , High-Frequency Ventilation , Incidence , Intensive Care, Neonatal , Pneumothorax , Respiratory Insufficiency , Sepsis , Ventilators, Mechanical , WeaningABSTRACT
High frequency ventilators(HFV) are introduced in such aspects as its contribution to the development of the ventilation, phylogeny, working principle in the physiological field, the advantages over normal-frequency ventilation, three common HFV modes and their application to medical therapy. The present situation of HFV is analyzed as well as it's developing trends and prospects.