Relationship between the dynamic oxygenated parameters and prognosis in acute respiratory distress syndrome in full-term neonates / 中华围产医学杂志

ABSTRACT

Objective To investigate the clinical significance in monitoring the dynamic oxygenated parameters in full-term neonates with acute respiratory distress syndrome (ARDS) and its relationship with the prognosis. Methods Forty-one full-term neonates with ARDS from 3 hospitals were divided into two groups according to the clinical outcomes: the death group (n=17) and the survival group (n=24). The parameters of breathing machine and arterial blood gas analysis in these two groups at 2 h, 12 h, 24 h and 36 h after mechanical ventilation were analyzed retrospectively. PaO_2/FiO_2, A-aDO_2, PaO_2/P_AO_2 and RI were calculated and compared between the two groups and within each group among the values of different period. Results Under the circumstance that parameters of breathing machine in the death group were obviously or gradually higher than those in the survival group, PaO_2 in the death group [(10.38?1.45)kPa] was lower than that in the survival group [(11.42?0.98)kPa] only at 36 h (P0.05). In the death group, PaO_2/FiO_2 at 24 h and 36 h [(15.86?4.92)kPa and (15.99?5.62)kPa] was lower than that in the survival group [(21.18?6.48)kPa and (27.12?8.33)kPa](P0.05) . Conclusions PaO2is not a sensitive indicator on the prognosisof NRDSinits early stage . PaO2/Fi O2, A-aDO2, PaO2/PAO2and RI are better than PaO2to reflectthe degree of lung injury ,oxygen exchange rate and therapeutic efficacy . A-aDO2and PaO2/PAO2arevery sensitive in assessing the therapeutic effect and the dynamic monitoring may be helpful injudgingthe prognosis .