Fernández MP, Limón AR, Hernáiz AMI, Hernández PM, López LC, García CC, López VJ, Villalpando del VE

Language: Spanish
References: 12
Page: 68-73
PDF size: 826.08 Kb.

ABSTRACT

Two newborn babies with severe hialine membrane disease and pulmonary hipertension were treated with high frequency oscilatory ventilation, using the Sensormedics 3100, (Sensormedics Co. Yorbalinda CA). The lung volume recruitment was achieved using a high volume strategy with a mean airway pressure used of 28 cm H₂O in the first case and of 20 cm H₂O in the second case plus the administration of oxigenous bovine surfactant, Survanta; (Ross Laboratories). A rapid pulmonary vasodilation was obtained in both cases. In 3 hours the PaO₂ changed from 40 mm Hg to 200 mm Hg in the first case and from 35 mm Hg to 160 mm Hg in the second case, using an FiO₂ of 1.0 and a frequency of 10 Hertz. The pulmonary artery pressure was estimated by the tricuspid insufficiency jet, bidimensional echocardiography, Doppler and color flow mapping and decreased from 60 mm Hg to 35 mm Hg in the first case and from 58 mm Hg to 30 mm Hg in the second case within 24 hours. The time of oscillation was the same in both cases: three days, the first patient was changed first to conventional mechanical ventilation and after that extubated. The second case was extubated directly from high frequency ventilation. The difference was that the first patient had more airway secretions and mucous plugs than the second one. The administration of supplemental O₂ beyond the 28th day of life was not necessary in both cases.

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