Improvement of postoperative atomized inhalation way in neonate with thoracotomy / 中国小儿急救医学

ABSTRACT

Objective To explore the suitable protocols of thoracotomy inhalation program for newborns, which will help to promote respiratory tract secretion drainage and to prevent the postoperative pulmonary complications.Methods This was a double-blind,randomized clinical trial.From January 2011 to October 2013 ,a total of 60 neonatal cases received thoracotomy were recruited,which included 45 cases of congenital esophageal atresia, and 15 cases of congenital diaphragmatic hernia.All cases were randomly allocated into treatment group and control group.Treatment group received mucosolvan 7.5 mg and saline 2 ml oxygen driven inhalation and the control group was given dexamethasone 1 mg, α-chymotrypsin 1 000 U plus saline 10 ml ultrasonic atomizing inhalation.The postoperative incidence of blood oxygen falling when receiving atomizing inhalation and numbers of sputum suction were compared between two groups.Results Compared with control group, the incidences of drop of blood oxygen were significantly deceased [the first day(0.40 ± 0.35) times vs.(1.53 ± 1.04) times;the second day (4.32 ± 0.40) times vs.(1.10 ± 1.06) times;the third day (0.51 ± 0.39) times vs.(1.20 ± 1.09) times;P ＜ 0.05], and the numbers of artificial sputum suction significantly deceased within 3 days after operation [the first day (7.37 ± 4.92) times vs.(13.24 ± 5.81)times;the second day (6.34 ± 3.84) times vs.(11.27 ± 4.64) times;the third day (6.01 ± 2.23) times vs.(10.20 ± 4.53) times;P ＜ 0.05].No adverse reactions were found during treatment.The incidence of blood oxygen falling and the numbers of artificial sputum suction showed no significant differences between two groups on day 4 and day 5 after operation(P ＞ 0.05).Conclusion It is important to have mucosolvan inhalation program for improving condition of respiration and respiratory secretions drainage for newborns with thoracotomy mucosolvan oxygen driven inhalation is worthy being used widely.