[Clinical effects of different ways of mechanical ventilation combined with pulmonary surfactant in treatment of acute lung injury/acute respiratory distress syndrome in neonates: a comparative analysis].
OBJECTIVE
To compare the therapeutic effects of high-frequency oscillatory ventilation+pulmonary surfactant (HFOV+PS), conventional mechanical ventilation+pulmonary surfactant (CMV+PS), and conventional mechanical ventilation (CMV) alone for acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in neonates.


METHODS
A total of 136 neonates with ALI/ARDS were enrolled, among whom 73 had ALI and 63 had ARDS. They were divided into HFOV+PS group (n=45), CMV+PS group (n=53), and CMV group (n=38). The neonates in the first two groups were given PS at a dose of 70-100 mg/kg. The partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), PaO2/fraction of inspired oxygen (FiO2), oxygenation index (OI), and respiratory index (RI) were measured at 0, 12, 24, 48, and 72 hours of mechanical ventilation.


RESULTS
At 12, 24, and 48 hours of mechanical ventilation, the HFOV+PS group had higher PaO2and lower PaCO2than the CMV+PS and CMV groups (P<0.05). At 12, 24, 48, and 72 hours of mechanical ventilation, the HFOV+PS group had higher PaO2/FiO2and lower OI and RI than the CMV+PS and CMV groups (P<0.05). The HFOV+PS group had shorter durations of mechanical ventilation and oxygen use than the CMV+PS and CMV groups (P<0.05). There were no significant differences in the incidence rates of air leakage and intracranial hemorrhage and cure rate between the three groups.


CONCLUSIONS
In neonates with ALI/ARDS, HFOV combined with PS can improve pulmonary function more effectively and shorten the durations of mechanical ventilation and oxygen use compared with CMV+PS and CMV alone. It does not increase the incidence of complications.
Department of Neonatology, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China. lhy5154@163.com.
Ming
M
Chang
Hong-Yan
HY
Lu
Hong
H
Xiang
Hou-Ping
HP
Lan
D055371:Acute Lung Injury / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics
D011663:Pulmonary Surfactants