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MECHANICAL VENTILATION FOR NEONATAL PULMONARY HEMORRHAGE Li Xiulian Huang Li Qing Hai
Provincial Women’s and Children’s Hospital, China Objective: Neonatal pulmonary hemorrhage is one of the
most common diseases causing neonatal death. The mortality rate of
pulmonary hemorrhage is as high as 96% before the application of mechanical
ventilation. However, the mortality rate of the disease decreased obviously
after we applied ventilation. In this article, we try to show early
diagnosis and the therapy of mechanical ventilation can make the mortality
rate of the disease decrease obviously. Methods: We treated 23 patients with respiratory
distress, cyanosis, pale color, severe scleredema, or very low birth weight
by mechanical ventilation. In addition, the blood gas showed type II
respiratory distress, and chest X-ray:“white lung” or cardiac enlargement, broaden rib interval,
diaphragm down. In the early of the disease, we applied to IPPV/PEEP
ventilation, and the original parameters: Fi02: 0.6-.0.8, PIP: 25-30cmH20,
RR: 30-40BPM, I/E: 2:1-1:1. In the course of ventilation, we monitored
blood gas one time per 4-6 hours, and adjudged no more than 2 parameters
based on the result of blood gas. Results: We monitored blood gas for every patient after
4 hours of ventilation. It showed Pa02 increased, but PaC02 decreased
obviously. After the therapy, 6 patients got well, 4 improved condition, 5
died, 8 discharged automatically. That is, the releasing rate is as high as
43.48%. Conclusion:
The theory of positive pressure
ventilation is that neonatal pulmonary hemorrhage is due to bleeding
pulmonary edema not vascular breakage. Positive pressure ventilation can
dilate atelectatic alveoli and reduce pulmonary vascular exudation. Thus,
Pa02 increased. In this case, it prevented the pulmonary injury from
hypoxia and acidosis. In short, the therapy for pulmonary hemorrhage is
early diagnosis and applying to positive ventilation in time. Otherwise,
nothing can be helpful.