title: Post-extubation atelectasis in newborns with surgical diseases: a report of two cases involving the use of a high-flow nasal cannula.
abstract: Atelectasis is a pulmonary disorder that lengthens the hospitalization time of newborns in intensive care units, resulting in increased morbidity among these infants. High-flow nasal cannulae have been used in newborns to prevent atelectasis and/or expand pulmonary regions affected by atelectasis; however, to date, no evidence-based data regarding this approach have been reported. In this paper, we report on the cases of two male newborn patients. The first and second patients described in this report were hospitalized for a neurosurgical procedure and the treatment of abdominal disease, respectively, and were subjected to invasive mechanical ventilation for 4 and 36 days, respectively. After extubation, these patients continued receiving oxygen therapy but experienced clinical and radiological worsening typical of atelectasis. In both cases, by 24 hours after the implantation of an high-flow nasal cannulae to provide noninvasive support, radiological examinations revealed the complete resolution of atelectasis. In these cases, the use of an high-flow nasal cannulae was effective in reversing atelectasis. Thus, this approach may be utilized as a supplemental noninvasive ventilatory therapy to avoid unnecessary intubation.
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Lúcia Cândida Soares
authors.initials: LC
authors.lastname: de Paula
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Fernanda Corsante
authors.initials: FC
authors.lastname: Siqueira
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Regina Célia Turola Passos
authors.initials: RC
authors.lastname: Juliani
authors.affiliation: Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Werther Brunow
authors.initials: WB
authors.lastname: de Carvalho
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria Esther Jurfest Rivero
authors.initials: ME
authors.lastname: Ceccon
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
mesh_terms: D060666:Airway Extubation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*