Resuscitation of infants with congenital diaphragmatic hernia.
Arch Dis Child Fetal Neonatal Ed
; 102(4): F320-F323, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-27920046
ABSTRACT
OBJECTIVE:
To determine whether the respiratory response to resuscitation in infants with congenital diaphragmatic hernia (CDH) as measured by a respiratory function monitor differed between those who did and did not survive.DESIGN:
Observational study.SETTING:
Tertiary perinatal centre. PATIENTS Thirty-eight infants born at 34â weeks of gestation or greater and diagnosed antenatally with a CDH.INTERVENTIONS:
Expiratory tidal volume (VTe), peak inflation pressure (PIP) and end-tidal carbon dioxide level (ETCO2) were simultaneously recorded during resuscitation using a respiratory function monitor. Oxygen saturation was also monitored. MAIN OUTCOMEMEASURES:
Mortality related to the median VTe, PIP, compliance (VTe divided by PIP) and ETCO2 levels in the first and last minute of recorded resuscitation and the maximum oxygen saturation.RESULTS:
The median gestational age, birth weight and duration of resuscitation of the 11 infants who died did not differ significantly from those who survived. During the first minute of recorded resuscitation, the VTe (median 1.89 vs 2.68â mL/kg) (p=0.009)), the ETCO2 (median 11.7 vs 41.7â mmâ Hg) (p=0.023)) and the compliance (0.06 vs 0.08â mL/cmâ H2O/kg) (p=0.018)) were lower in the non-survivors. In the last minute, the PIP was higher (32.5 vs 30.3â cmâ H2O) (p=0.03)), the VTe (3.22 vs 4.66â mL/kg) (p=0.003)) and compliance (0.10 vs 0.15â mL/cmâ H2O/kg) (p=0.004)) were lower in the non-survivors. The maximum oxygen saturation achieved in the labour suite was lower in the non-survivors (93% vs 100%) (p=0.037).CONCLUSIONS:
Infants with CDH who did not survive responded less well even to initial resuscitation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Ressuscitação
/
Complacência Pulmonar
/
Ventilação Pulmonar
/
Hérnias Diafragmáticas Congênitas
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
Idioma:
En
Revista:
Arch Dis Child Fetal Neonatal Ed
Assunto da revista:
PEDIATRIA
/
PERINATOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido