A panel of indices in newborns with birthweight more than 2500 grams treated with conventional ventilation during the neonatal period.
Intelligent application of the monitoring methods forms the mainstay of the diagnostic and treatment strategy in intensive care and is in harmony with the basic principle of minimal handling in neonatal intensive care. Thus, based on the monitoring data it is possible to derive a number of equipment, oxygen-derivative, respiratory, hemodynamic, metabolic and other indices. The information provided by these indices is significantly greater and more important than that gained from the initial data (ventilatory parameters) and biologic variables). It is of foremost importance for the successful performance of both conventional and nonconventional ventilation techniques and the evaluation of the newborn status as well as for prognostic discussions and conclusions. In the present study we used the Neonatal Intensive Computer File developed by the author with graphic trends for visualization of the dynamics of indices over time in each and every one of the neonates in our groups of patients which are statistically analyzed using standard methods and computer models. A total of 30 neonates (14 survived and 16 non-survived) who had been treated with conventional ventilation during the neonatal period were enrolled in the study. Our results show that: 1. The dynamics of indices between the survived and the non-survived shows significant differences in terms of values, dynamics and general tendency. 2. Major relationships between the different indices are observed and their correct interpretation improves the information yield of each and every one of the above-mentioned indices. There are identical tendencies in the dynamics of MAP, OI and VI values in the survived whereas in the non-survived these indices are discordant. The improvement in a/A values coincides in time with that of AaDO2 reduction, or the improvement in oxygenation is accompanied by a reduction of the degree of shunting in the survived which is a favorable prognostic indication, whereas decrease in a/A values in the presence of practically unchanged AaDO2 values suggests an unfavorable outcome. The improvement in compliance is accompanied by improvement in the rate of oxygenation in the survivor group whereas in the non-survivors the deterioration in oxygenation is accompanied by a decrease in compliance and reflects the major underlying pathologic mechanism of gas exchange. 3. The panel of indices used by us specifies exactly the onset of the changes in gas exchange. 4. The application of the panel of indices contributes to more profound diagnostic reasoning and conclusions as well as the therapy and prognosis ad vitam.
Despotova-Toleva
L
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Surgical Pediatric Intensive Care Unit, Higher Medical Institute, Plovdiv.
D001724:Birth Weight; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial
D010100:Oxygen