Nasal intermittent mandatory ventilation combined with pulmonary surfactant for the treatment of neonatal hyaline membrane disease / 中国小儿急救医学

ABSTRACT

Objective To evaluate the effect of nasal intermittent mandatory ventilation (NIMV)combined with pulmonary surfactant for the treatment of hyaline membrane disease in premature children and to compare the clinical efficacy with conventional mechanical ventilation and continuous positive airway pressure (CPAP). Methods Seventy-four babies with severe respiratory syndrome were given curosurf[100 mg/(kg·dose)],25 of them were given to NIMV, another 25 were given conventional intermittent mandatory ventilation (IMV), the last 24 patients were given conventional CPAP. Blood gas analysis parameters and incidences of respiratory complications including respiratory tract infection and chronic lung disease,frequent apnea and carbon dioxide retention, were compared among the three groups. Results After treatment of 1 h, symptoms and signs of the patients markedly improved. All the three groups showed an increase in arterial oxygen partial pressure, but arterial pressure of carbon dioxide and oxygen index decreased significantly by the time of 6,12,24 h after treatment and there were not significantly difference among the three groups. The rates of respiratory infection and chronic lung disease in NIMV group were less than that of conventional IMV group[(8% vs 36% ) ,(20% vs 72% )],the rates of frequent apnea and carbon dioxide retention in NIMV group were less than that of CPAP group[(8% vs 36% ), (20% vs 72% )]. Conclusion NIMV combined with pulmonary surfactant is a potentially efficient therapy for hyaline membrane disease in premature infants. NIMV treatment of hyaline membrane disease in premature infants can reduce or avoid ventilation-associated pneumonia,chronic lung disease and other complications,but also efficiently reduce the incidence of frequent apnea and carbon dioxide retention.