Lung Protective Ventilation Strategies in Treatment of Neonatal Respiratory Failure

Objective To observe the effect of mechanical ventilation with lung protective ventilation strategies and respiratory mechanics adopted for monitoring in the treatment of neonatal respiratory failure,aiming to decrease the incidence of ventilator-associated lung injury(VALI).Methods 56 cases infants with respiratory failure,who were admitted to neonatal intensive care unit (NICU) from June 2007-Octorber 2008 and treated with mechanical ventilation (SIMV mode),were randomly divided into conventional mechanical ventilation (CMV) group and lung protective ventilation (LPV) group.Data relevant to the neonates were collected and analyzed,including the ventilator's parameter,blood gas,pulmonary function test,complications and therapeutic effectiveness.Results Peak inspiratory presure(PIP),mean airway presure(MAP),inspriratory time(Ti) respectively in the LPV group were significantly lower than those in the CMV group(P0.01).The results in arterial blood gas study show that only PaCO2 of the LPV group was higher than that in the CMV group(P0.01),which lasted for 24-48 h after ventilation.The incidence of VALI(P0.05)and mechanical ventilation time(P0.01)were significantly lower than those in the CMV group while the therapeutic effectiveness of the LPV group was better than that of the CMV group(P0.05).There were no differences in FiO2,PaO2 and pH of arterial blood gas,HR,BP at any time of ventilation(P0.05).There were also no differences in the length of hospitalization,incidence of intraventricular hemorrhage and periventricular leukomalacia(IVH)(P0.05).Conclusions LPV can markedly decrease the incidence of VALI and mechanical ventilation time,without affecting oxygenation.It can also lead to slight increase of PaCO2,good recovering of kidneys,and no changes in the incidence of IVH and PVL.