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[High frequency oscillation in meconium aspiration and bronchopulmonary dysplasia].
Klin Padiatr. 1994 Mar-Apr; 206(2):80-5.KP

Abstract

Within one year 3 newborns with meconium-aspiration and 4 infants with bronchopulmonary dysplasia (BPD) were treated with HFP, synchronous with conventional ventilation (CMV). The entrance criteria were insufficient oxygenation (PO2/FiO2 < 50 mmHg) and/or CO2-elimination (> 60 mmHg), respectively peak inspiratory pressure Pi > 40 mmHg and mean airway pressure MAP > 20 mbar during CMV. All three cases of meconium-aspiration have shown a striking improvement in oxygenation and ventilation, in one case starting from a disastrous situation with PCO2 > 90 mmHg, PO2 30 mmHg (FiO2 100%). After a HFO period of 9 to 10 hours Pi, MAP and CMV-frequency could be reduced. The patients could be extubated after 1-2 weeks. In severe BPD only in one case continuous improvement and extubation in the 4. week of life were possible. Here the pulmonary artery pressure in doppler-echocardiography slightly was elevated (30-35 mmHg). In a further case extubation was possible after several trials with HFO. Indeed chronic respiratory insufficiency, progredient pulmonary emphysema on x-ray and clearly elevated pulmonary artery pressure (> 40 mmHg) persisted. In 2 further cases there was no longstanding improvement of ventilation. One child died after 8 months, one after 6 months. In both cases there was a right-to-left shunt over foramen ovale and pulmonary artery pressures at systemic level. HFO led to an improvement in oxygenation and ventilation in all three cases of meconium-aspiration and probably prevented a fatal outcome in one case. The effect seems to depend on improved secretolysis and gas exchange.(

ABSTRACT

TRUNCATED AT 250 WORDS)

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Authors+Show Affiliations

Herterich R
Kinderklinik St. Marien Landshut.
Fackeldey E
No affiliation info available
Hofweber K
No affiliation info available
Steck W
No affiliation info available
Neumaier F
No affiliation info available
Arends H
No affiliation info available

MeSH

Bronchopulmonary DysplasiaCarbon DioxideFemaleFollow-Up StudiesHemodynamicsHigh-Frequency VentilationHumansHypertension, PulmonaryInfant, NewbornMaleMeconium Aspiration SyndromeOxygen

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

8196311

Citation

Herterich, R, et al. "[High Frequency Oscillation in Meconium Aspiration and Bronchopulmonary Dysplasia]." Klinische Padiatrie, vol. 206, no. 2, 1994, pp. 80-5.
Herterich R, Fackeldey E, Hofweber K, et al. [High frequency oscillation in meconium aspiration and bronchopulmonary dysplasia]. Klin Padiatr. 1994;206(2):80-5.
Herterich, R., Fackeldey, E., Hofweber, K., Steck, W., Neumaier, F., & Arends, H. (1994). [High frequency oscillation in meconium aspiration and bronchopulmonary dysplasia]. Klinische Padiatrie, 206(2), 80-5.
Herterich R, et al. [High Frequency Oscillation in Meconium Aspiration and Bronchopulmonary Dysplasia]. Klin Padiatr. 1994 Mar-Apr;206(2):80-5. PubMed PMID: 8196311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [High frequency oscillation in meconium aspiration and bronchopulmonary dysplasia]. AU - Herterich,R, AU - Fackeldey,E, AU - Hofweber,K, AU - Steck,W, AU - Neumaier,F, AU - Arends,H, PY - 1994/3/1/pubmed PY - 1994/3/1/medline PY - 1994/3/1/entrez SP - 80 EP - 5 JF - Klinische Padiatrie JO - Klin Padiatr VL - 206 IS - 2 N2 - Within one year 3 newborns with meconium-aspiration and 4 infants with bronchopulmonary dysplasia (BPD) were treated with HFP, synchronous with conventional ventilation (CMV). The entrance criteria were insufficient oxygenation (PO2/FiO2 < 50 mmHg) and/or CO2-elimination (> 60 mmHg), respectively peak inspiratory pressure Pi > 40 mmHg and mean airway pressure MAP > 20 mbar during CMV. All three cases of meconium-aspiration have shown a striking improvement in oxygenation and ventilation, in one case starting from a disastrous situation with PCO2 > 90 mmHg, PO2 30 mmHg (FiO2 100%). After a HFO period of 9 to 10 hours Pi, MAP and CMV-frequency could be reduced. The patients could be extubated after 1-2 weeks. In severe BPD only in one case continuous improvement and extubation in the 4. week of life were possible. Here the pulmonary artery pressure in doppler-echocardiography slightly was elevated (30-35 mmHg). In a further case extubation was possible after several trials with HFO. Indeed chronic respiratory insufficiency, progredient pulmonary emphysema on x-ray and clearly elevated pulmonary artery pressure (> 40 mmHg) persisted. In 2 further cases there was no longstanding improvement of ventilation. One child died after 8 months, one after 6 months. In both cases there was a right-to-left shunt over foramen ovale and pulmonary artery pressures at systemic level. HFO led to an improvement in oxygenation and ventilation in all three cases of meconium-aspiration and probably prevented a fatal outcome in one case. The effect seems to depend on improved secretolysis and gas exchange.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0300-8630 UR - https://www.unboundmedicine.com/medline/citation/8196311/[High_frequency_oscillation_in_meconium_aspiration_and_bronchopulmonary_dysplasia]_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2008-1046587 DB - PRIME DP - Unbound Medicine ER -