phenylephrine-hydrochloride and Hyaline-Membrane-Disease

Topics: Humans; Hyaline Membrane Disease; Infant; Infant, Newborn; Nasopharynx; Nose; Pharynx; Positive-Pressure Respiration; Pressure

Continuous positive airway pressure (CPAP) by means of a bilateral nasal cannula system has been used in 21 newborns. 15 had hyaline membrane disease, 3 had an aspiration and 3 showed extensive atelectasis. In 18 of the 21 patients, paO2 increased after cannulation, FiO2 being kept unaltered. As a consequence, the oxygen concentration in the inspired gas mixture could be lowered. 3 children had to be intubated endotracheally and ventilated artificially despite previous nasal cannulation. The criteria for using the CPAP and the methodology are described, its advantages, disadvantages and dangers discussed.

Topics: Humans; Hyaline Membrane Disease; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Inhalation; Methods; Nose; Oxygen; Partial Pressure; Positive-Pressure Respiration; Pressure; Pulmonary Alveoli; Pulmonary Atelectasis; Respiration; Respiratory Distress Syndrome, Newborn

This report describes one year's experience treating hyaline membrane disease (HMD) with nasal end-expiratory pressure (NEEP). During the 12 months from July 1, 1973 through June 30, 1974, 119 children with HMD were admitted to the Intensive Care Unit of St. Paul Children's Hospital. Sixty-nine infants were treated early in the course of their disease with NEEP. The survival, incidence of complications, and the number of endotracheal intubations are reported and compared to our experience during a similar time period prior to the use of NEEP (1971-1972). Since the advent of the early application of modest amounts of end-expiratory pressure by nasopharyngeal tube, there has been an increase in the survival of all admissions with HMD, but the increase was statistically significant (P less than .01) only in those weighing 1,501 to 2,000 gm. There was a significant decrease (P less than .025) in the total number of children with HMD requiring endotracheal intubation. There was no change in the incidence of pneumothoraces or bronchopulmonary dysplasia. NEEP is a simple and effective technique for creating continuous airway distending pressure. Its effectiveness and ready availability make the routine endotracheal intubation of infants requiring only continuous airway distending pressure no longer justifiable.

Topics: Blood Gas Analysis; Humans; Hyaline Membrane Disease; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Nasal Cavity; Nose; Positive-Pressure Respiration; Radiography; Respiratory Distress Syndrome, Newborn; Ventilators, Mechanical

Topics: Asphyxia; Asphyxia Neonatorum; Congenital Abnormalities; Humans; Hyaline Membrane Disease; Infant, Newborn; Nose; Nose Deformities, Acquired; Surgical Procedures, Operative