Efficacy of high frequency oscillatory ventilation combined with pulmonary surfactant for treating neonatal meconium aspiration syndrome

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Author:
CAI Cheng(Department of Neonatal Intensive Care Unit,Ning Bo Women and Children's Hospital,Ningbo 315012,China)
L(U) Qin(Department of Neonatal Intensive Care Unit,Ning Bo Women and Children's Hospital,Ningbo 315012,China)
WU Jun-hua(Department of Neonatal Intensive Care Unit,Ning Bo Women and Children's Hospital,Ningbo 315012,China)
Journal Title:
Chinese Journal of Perinatal Medicine
Issue:
Volume 15, Issue 06, 2012
DOI:
10.3760/cma.j.issn.1007-9408.2012.06.009
Key Word:
Meconium aspiration syndrome;Pulmonary surfactants;High-frequency ventilation

Abstract: Objective To explore the clinical effects of high frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) on neonatal meconium aspiration syndrome (MAS).Methods Data of 53 newborns with MAS admitted into the Neonatal Intensive Care Unit of Ning Bo Women and Children's Hospital from June 2008 to June 2011 were retrospectively analyzed.According to different therapeutic measures,they were divided into three groups:conventional mechanical ventilation (CMV) group (n=23),HFOV group (n=18) and HFOV+PS group (n=12).The oxygen index,arterial oxygen/alveolar oxygen ratio (a/ApO2) and inspired oxygen fraction (FiO2) were monitored at 2,12,24 and 48 h after mechanical ventilation.The mechanical ventilation time,duration of hospital stay,change of symptom,complications and clinical outcomes of the three groups were compared by analysis of variance and Chi-square test.Results The parameters of the three groups at 2 and 48 h after mechanical ventilation were as followed:CMV group [oxygen index:(23.79±7.27) and (15.04±4.76) mm Hg; a/ApO2:0.11±0.04 and 0.31 ±0.07; FiO2:0.74±0.16 and 0.47± 0.21],HFOV group [oxygen index:(21.13±6.29) and (11.73±4.54) mm Hg; a/ApO2:0.14±0.06 and 0.35±0.06; FiO2:0.68±0.14 and 0.41±0.11] and HFOV+ PS group [oxygen index:( 18.35 ± 5.68 ) and ( 7.85 ± 5.06 )mm Hg; a/ApO2:0.17±0.03 and 0.40±0.02; FiO2:0.59±0.13 and 0.29±0.16].Compared with CMV group,the parameters of HFOV group and HFOV+ PS group were different at different time points,and the parameters (duration and extent) of HFOV+ PS group were better than those of HFOV group (all P<0.05).The mechanical ventilation time was (7.2±0.6) days in CMV group,(4.2± 1.4) days in HFOV group and (2.9±0.5) days in HFOV+PS group; the hospital stay was (22.2±4.5) days in CMV group,(15.6±3.4) days in HFOV group and (11.8±4.3) days in HFOV+PS group; and the oxygen treatment time was (15.4± 2.4) days in CMV group,(11.8±5.3) days in HFOV group and (7.4±2.2) days in HFOV+PS group.The mechanical ventilation time,oxygen treatment time and hospital stay time were the longest in CMV group,the shortest in HFOV+ PS group (P< 0.05,respectively).Conclusions Early HFOV combined with PS might be a better therapeutic method for infants with MAS than HFOV or CMV alone.

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