Effects of lung protective ventilation strategies on oxygenation in respiratory distress syndrome neonates

Objective To explore the effects of lung protective ventilation strategies on oxygenation in the treatment of neonatal respiratory distress syndrome and to evaluate clinical value.Methods Forty newborn infants,diagnosed as neonatal respiratory distress syndrome and in need of ventilation support,were divided into protective ventilation(PV) group and conventional ventilation(CV) group randomly.The ventilator settings,arterial blood gas analysis,oxygenation index factors,complications and other clinical data were analyzed and compared between the two groups.Results(1) In the PV group,ventilator settings such as PIP,MAP and FiO2 were significantly less than that in CV group(P0.05).PEEP was higher than that of CV group(P0.01).No difference was noted in respiratory rate between the two groups.(2) Compared with CV group,PaCO2 was increased significantly in PV groups(P0.01) and pH was decreased(P0.01).PaO2 showed no significant difference between the two groups.(3) OI in PV group was significantly less than that in CV group at 48 h and 72 h after mechanical ventilation(P0.01).At 72 h after mechanical ventilation,a/APO2 in PV group was significantly higher than that in CV group(P0.01).There was no significant difference in PaO2/FiO2(P0.05).(4) Incidence of ventilator-associated lung injury in PV group was significantly decreased than that in CV group(P0.05).(5) No differences were noted in the incidences of IVH and PDA.The duration of mechanical ventilation in PV group was significantly shorter than that in CV group(P0.01).There was no significant difference of mortality between the two groups.Conclusion Protective ventilation strategies in the treatment of neonatal RDS can improve lung oxygenation,keep appropriate PaO2,reduce the ventilator-associated lung injury,shorten the duration of mechanical ventilation,decrease mortality,improve the patient's living quality,but do not increase the incidence of IVH and PDA.