Document Detail


Respiratory distress associated with inadequate mechanical ventilator flow response in a neonate with congenital diaphragmatic hernia.
MedLine Citation:
PMID:  20196885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence of congenital diaphragmatic hernia has been reported as 0.17-0.66 per 1,000 births. Despite advances in neonatal intensive care, congenital diaphragmatic hernia is associated with high mortality and morbidity. We report a neonate who was born with a left congenital diaphragmatic hernia and underwent surgical repair. The lack of ventilator flow response and flow cycling was identified via interpretation of the ventilator graphic and clinical assessment. Presumably, the ventilator failed to respond to the patient's peak inspiratory flow demand, despite the clinician's setting the highest peak flow available. A time-cycled pressure-limited mode with adjustable peak flow rate was the only option that met the infant's flow requirement, and alleviated the respiratory distress. This clinical finding follows bench research that raises the concern that so called "cradle-to-grave" ventilators may not optimally support all neonates.
Authors:
Brian K Walsh; Nancy Craig; Peter Betit; John E Thompson; John H Arnold
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  55     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-03     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-5     Citation Subset:  IM    
Affiliation:
Respiratory Care Department, Children's Hospital Boston, Boston, Massachusetts 02115, USA. brian.walsh@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Equipment Failure Analysis
Hernia, Diaphragmatic / complications*,  congenital*,  surgery
Humans
Infant, Newborn
Male
Respiration, Artificial / adverse effects*
Respiratory Distress Syndrome, Newborn / etiology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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