Document Detail


Lung Recruitment Maneuver during Volume Guarantee Ventilation of Preterm Infants with Acute Respiratory Distress Syndrome.
MedLine Citation:
PMID:  21380992     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Preterm infants need the achievement of adequate lung volume. Lung recruitment maneuver (LRM) is applied during high-frequency oscillatory ventilation. We investigated the effect of an LRM with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in infants conventionally ventilated for respiratory distress syndrome (RDS). Preterm infants in assisted controlled ventilation + volume guarantee for RDS after surfactant randomly received an LRM (group A) or did not (group B). LRM entailed increments of 0.2 cm H (2)O PEEP every 5 minutes, until fraction of inspired oxygen (Fi O(2)) = 0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve. When saturation of peripheral oxygen fell and Fi O(2) rose, we reincremented PEEP until Sp O(2) became stable. Group A ( N = 10) and group B ( N = 10) infants were similar: gestational age 25 ± 2 versus 25 ± 2 weeks; body weight 747 ± 233 versus 737 ± 219 g; clinical risk index for babies 9.8 versus 8.1; initial Fi O(2) 56 ± 24 versus 52 ± 21, respectively. LRM began at 86 ± 69 minutes of age and lasted for 61 ± 18 minutes. Groups A and B showed different max PEEP during the first 12 hours of life (6.1 ± 0.3 versus 5.3 ± 0.3 cm H (2)O, P = 0.00), time to lowest Fi O(2) (94 ± 24 versus 435 ± 221 minutes; P = 0.000) and O (2) dependency (29 ± 12 versus 45 ± 17 days; P = 0.04). No adverse events and no differences in the outcomes were observed. LRM led to the earlier lowest Fi O(2) of the first 12 hours of life and a shorter O (2) dependency.
Authors:
Francesca Castoldi; Irene Daniele; Paola Fontana; Francesco Cavigioli; Enrica Lupo; Gianluca Lista
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-4
Journal Detail:
Title:  American journal of perinatology     Volume:  -     ISSN:  1098-8785     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© Thieme Medical Publishers.
Affiliation:
Neonatal Intensive Care Unit, V. Buzzi Children's Hospital ICP, Milan, Italy.
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