ABSTRACT
Adequate artificial ventilation (AV) is one of the most important problems in modern neonatal anesthesiology. Various earlier classical AV modes had a number of limitations that presented problems in the work of surgical and anesthesiological teams at surgery. The capacities of high-frequency AV (HFAV) even in the presence of a wide tracheoesophagostomy to generate an effective pressure in the lung make the HFA V mode irreplaceable in neonatal surgery, by reducing postoperative mortality rates from 10.9% in 1990-1995 to 6.8% in 1996-2007 The present paper evaluates the efficiency of volumetric HFA Vperformed in the anesthetic maintenance in neonatal infants with esophageal atresia, by comparing the data of a clinical observation, the results of studying blood gas composition, acid-base balance, and hemodynamics in 2 patient groups differing in the mode of AV. Group 1 received myorelaxants and underwent assisted mask AV, followed by classical ASV after tracheal intubation. In Group 2, the trachea was intubated in the presence of preserved spontaneous respiration, during basic anesthesia, volumetric HFAV at a respiration rate of 120-140 per min, FiO2 70%, PiP 8-10 cm H2O, PeeP 2 cm H2O; I:E 1:2. The used volumetric HFAV procedure ensures a more stable course of anesthesia, produces an effective and easily controlled mean pressure in the airway, provides better oxygenation, prevents severe acid-base balance changes, and reduces the cardiosuppressive effect of AV, by improving the hemodynamic parameters.
