Ventilatory management in extremely low birth weight infants.

摘要: The improvement in survival premature infants associated with the evolution of mechanical ventilation has been accompanied by an increase ventilator induced lung injury. High frequency shown to reduce incidence injury and hence chronic disease very low birth weight infant. understanding how best use high this population prompted us ask whether similar strategies optimize volumes on conventional can minimize neonate. We retrospectively reviewed medical charts 51 extremely born Kingston, Ontario two epochs, 1990 1991 1999 2000, for ventilatory strategy outcome. From our review, it is clear that surfactant therapy rapidly changes mechanics improving pulmonary compliance damage may result if there are not management reflect altered compliance. Early during apparently stable "honeymoon period" a patient respiratory distress syndrome (RDS) significant implications long term morbidity. In era prior surfactant, 30% died 40% developed (CLD). Immediately following , mortality was reduced 18%, however, CLD increased 78%. most recent era, 10 years experience ventilation, morbidity 17% 21%. This study demonstrates particularly crucial time immediate period administration. lower peak inspiratory pressure (PIP) mean airway (MAP) over first 24 hours synchronous intermittent mandatory (SIMV) improved challenge remaining determine utilize mode volume protect immature lung.