2615

THE 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.