HFOV plus SIMV in the treatment of neonatal meconium aspiration syndrome

Objective: To observe the effect of HFOV plus SIMV in the treatment of neonates with meconium aspiration syndrome.Methods: 12 neonates with meconium aspiration syndrome were managed with HFOV plus SIMV.During HFOV plus SIMV,the minimum pressure strategy was performed,which was to achieve pulse oxygen saturation(SpO2) 0.9 and fraction of inspired oxygen(FiO2) 0.6 by gradually increasing mean airway pressure(MAP).Arterial partial pressure of carbon dioxide(PaCO2) was maintained in the normal range by adjusting pressure amplitude(△P) and oscillation frequency(f).The heart rate(HR),blood pressure(BP),arterial blood gas analysis,the oxygenation index and ventilator parameters were monitored during the course of the ventilation.Results: During 48 hours after the ventilation,there were steady reductions in oxygenation index(OI),FiO2,△P and MAP.There were statistically significant differences in OI(F=12.996,P=0.000),mean airway pressure(F=8.712,P=0.000),FiO2(F=29.095,P=0.000),△P(F=5.587,P=0.001) and MAP(F=8.712,P=0.000) at all time points.There were no statistically significant differences in HR(F=1.095,P=0.386) and BP(F=0.764,P=0.553) at all time points.Conclusion: HFOV plus SIMV are safe and effective in the treatment of neonates with meconium aspiration syndrome.