Effect of high frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of acute respiratory distress syndrome after cardiac surgery: a prospective randomized controlled trail

2021 ◽  
Author(s):  
Yi-Rong Zheng ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hong-Lin Wu ◽  
Ning Xu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
High Frequency ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
High Frequency Oscillatory ◽  
Length Of Hospitalization

Abstract Objective: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery.Method: A total of 61 infants with ARDS were eligible and were randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31) between January 2020 and December 2020. The primary outcomes were the improvement of the arterial blood gas analysis. The incidence of mechanical ventilation duration, length of hospitalization, and the incidence of complications were considered as secondary outcomes.Results: A total of 61 infants completed the study. In HFOV + PS group, the blood gas analysis results were significantly improved (P<0.05), while, duration of mechanical ventilation and length of hospitalization were shorter than CMV + PS group (P<0.05). But the incidences of complications had no statistical significance between the two groups (P>0.05).Conclusions: Compared with the CMV + PS group, HFOV + PS significantly improved the ABG variables and shortened the length of hospitalization and mechanical ventilation in infants with ARDS after cardiac surgery.

scholarly journals Effect of High-Frequency Oscillatory Ventilation Combined With Pulmonary Surfactant in the Treatment of Acute Respiratory Distress Syndrome After Cardiac Surgery: A Prospective Randomised Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Yi-Rong Zheng ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hong-Lin Wu ◽  
Ning Xu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Acute Respiratory Distress Syndrome ◽  
High Frequency ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
High Frequency Oscillatory Ventilation ◽  
Blood Gas ◽  
High Frequency Oscillatory

Background: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery.Methods: A total of 61 infants with ARDS were eligible and were randomised to the CMV + PS group (n = 30) or the HFOV + PS group (n = 31) between January 2020 and December 2020. The primary outcomes were the changes in arterial blood gas parameters. The duration of mechanical ventilation, length of hospitalisation and the incidence of complications were considered secondary outcomes.Results: A total of 61 infants completed the study. In the HFOV + PS group, the blood gas analysis results were significantly improved (P &lt; 0.05), while the duration of mechanical ventilation and length of hospitalisation were shorter than the CMV + PS group (P &lt; 0.05). However, the incidence of complications was not different between the two groups (P &gt; 0.05).Conclusions: Compared with the CMV + PS group, the HFOV + PS group showed significantly improved ABG variables and had a shortened length of hospitalisation and mechanical ventilation in infants with ARDS after cardiac surgery.Clinical Trial Registration: Chinese Clinical Trial Registry; Number: ChiCTR2000039457.

Blood gas analysis in newborns with low cardiac output syndrome after cardiac surgery.

2018 ◽  
Vol 19 (5) ◽  
pp. 676-687
Author(s):  
G.G. Khubulava ◽  
A.B. Naumov ◽  
S.P. Marchenko ◽  
O.Yu. Chupaeva ◽  
A.A. Seliverstova ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output

Nasal High-Frequency Oscillatory Ventilation in Preterm Infants with Moderate Respiratory Distress Syndrome: A Multicenter Randomized Clinical Trial

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Xingwang Zhu ◽  
Zhichun Feng ◽  
Chengjun Liu ◽  
Liping Shi ◽  
Yuan Shi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Preterm Infants ◽  
High Frequency ◽  
Primary Outcome ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Risk Difference ◽  
High Frequency Oscillatory Ventilation ◽  
High Frequency Oscillatory

<b><i>Objective:</i></b> To determine whether nasal high-frequency oscillatory ventilation (NHFOV) as a primary mode of respiratory support as compared with nasal continuous airway pressure (NCPAP) will reduce the need for invasive mechanical ventilation in preterm infants (26<sup>0/7</sup>–33<sup>6/7</sup> weeks of gestational age [GA]) with respiratory distress syndrome (RDS). <b><i>Methods:</i></b> This multicenter randomized controlled trial was conducted in 18 tertiary neonatal intensive care units in China. A total of 302 preterm infants born at a GA of 26<sup>0/7</sup>–33<sup>6/7</sup> weeks with a diagnosis of RDS were randomly assigned to either the NCPAP (<i>n</i> = 150) or the NHFOV (<i>n</i> = 152) group. The primary outcome was the need for invasive mechanical ventilation during the first 7 days after birth. <b><i>Results:</i></b> Treatment failure occurred in 15 of 152 infants (9.9%) in the ­NHFOV group and in 26 of 150 infants (17.3%) in the NCPAP group (95% CI of risk difference: −15.2 to 0.4, <i>p =</i> 0.06). In the subgroup analysis, NHFOV resulted in a significantly lower rate of treatment failure than did NCPAP in the strata of 26<sup>+0/7</sup>–29<sup>+6/7</sup>weeks of GA (11.9 vs. 32.4%, 95% CI of risk difference: −39.3 to −1.7, <i>p =</i> 0.03) and birth weight &#x3c;1,500 g (10.4 vs. 29.6%, 95% CI of risk difference: −33.8 to −4.6, <i>p =</i> 0.01). The rate of thick secretions causing an airway obstruction was higher in the NHFOV group than in the NCPAP group (13.8 vs. 5.3%, 95% CI of risk difference: 1.9–15.1, <i>p =</i> 0.01). No significant differences in other secondary outcomes were found between the NHFOV and NCPAP groups. <b><i>Conclusions:</i></b> NHFOV was not superior to NCPAP with regard to the primary outcome when applied as the primary respiratory support for RDS in infants between 26<sup>+0/7</sup> and 33<sup>+6/7</sup> weeks of GA. In the subgroup analysis, NHFOV seemed to improve effectiveness than NCPAP in preterm infants &#x3c;30 weeks of GA.

scholarly journals Effects of a Combination of Prone Positioning and High-Frequency Oscillatory Ventilation on Blood Gas Exchange in an Experimental Pig Model of Acute Respiratory Distress Syndrome Efekti Kombinacije Ležećeg Položaja I Oscilatorne Plućne Ventilacije Visoke Frekvencije Na Razmenu Gasova U Krvi Na Modelu Sindroma Akutnog Respiratornog Šoka Kod Svinja

2014 ◽  
Vol 64 (3) ◽  
pp. 307-318
Author(s):  
Žurek Jiří ◽  
Dominik Petr ◽  
Košut Peter ◽  
Šeda Miroslav ◽  
Fedora Michal
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Gas Exchange ◽  
Prone Position ◽  
High Frequency ◽  
Distress Syndrome ◽  
High Frequency Oscillatory Ventilation ◽  
Prone Positioning ◽  
Blood Gas ◽  
Oscillatory Ventilation ◽  
High Frequency Oscillatory

Abstract This animal study was conducted in order to verify the effects of combining highfrequency oscillatory ventilation and prone positioning and the order of application of both methods on blood gas exchange in an experimental model of acute respiratory distress syndrome. Forty domestic pigs were used for the study. Saline solution washout was produced by bilateral lung lavage. The lavage process was repeated until adequate impairment of gas exchange (defined as PaO2 < 100 mmHg) 60 min following the last lavage was achieved. Subsequently, lung injury was established and each model was randomized to one of five groups, with differences in the type of mechanical ventilation used (conventional mechanical ventilation in accordance with the principles of protective lung ventilation or high-frequency oscillatory ventilation) and also in the positioning of the experimental model (supine position or mode changing prone and supine positions in a ratio 18:6 hours). The best oxygenation was achieved in the group prone position + high-frequency oscillatory ventilation. The most favorable combination in terms of carbon dioxide elimination is the high-frequency oscillatory ventilation + prone position. The best results in terms of oxygenation index value were obtained in the combination of a prone position with the high-frequency oscillatory ventilation and in the prone position. In conclusion, by using combinations of prone positioning and high-frequency oscillatory ventilation, one can achieve better blood gas parameters during acute respiratory distress syndrome.

scholarly journals Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

2019 ◽  
Author(s):  
Han Han ◽  
Xiao-xia Li ◽  
Xiang-hua Shuai ◽  
Zhi-qun Zhang ◽  
Jing Li ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Rescue Therapy ◽  
Total Duration ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Systemic Hemodynamic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: Mechanical ventilation joint PS replacement therapy is an effective method in treatment of NRDS recognized, PS treatment of children with early can improve the oxygenation by increasing gas exchange area, but before FiO 2 to reduce the application of PS can cause local and/or systemic hemodynamic changes, making the use of PS has some potential problems, such as increasing the incidence of the IVH, PH, PDA and so on. SR rescue therapy can be divided into early treatment and delayed treatment, but the specific boundary point of the appropriate time period has not been clear. This paper aims to compare the efficacy differences of PS administration at different time periods and provide basis for the selection of clinical application period of PS. Methods: Case-control study . 135 children diagnosed with NRDS in neonatology department of our hospital. The patients were divided into two groups according to the use time of PS. Group A was applied within 3 hours after birth, and group B was applied 3 hours after birth. The changes of blood gas analysis parameter，mechanical ventilation time, incidence of complications, hospital stay and mortality were compared between the two groups. Results : The decrease of blood gas PaCO 2 in group A before and after treatment was more significant than that of group B (P<0.05), but the improvement of PaO 2 and OI in group B was better than that in group A (P<0.05). Although there were significant differences in birth weight between the two groups, there were no significant differences in the total duration of mechanical ventilation and mortality (P>0.05). Except PDA and BPD, there was no significant difference in the incidence of common complications between the two groups. Conclusion: PS treatment within 3 hours after birth can better improve ventilation, reduce the incidence of PDA. It can also help to reduce the death rate of high-risk children and the total duration of mechanical ventilation.

scholarly journals Perbandingan Nilai PETCO2 dan PACO2 pada Pasien dengan Pemasangan Ventilasi Mekanik

1970 ◽  
Vol 4 (1) ◽  
Author(s):  
Baskoro Soetioputro ◽  
F. Sri Susilaningsih ◽  
Titin Mulyati
Keyword(s):  
Mechanical Ventilation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Regulation Of Respiration ◽  
Blood Gas ◽  
Altman Plot ◽  
Cross Sectional ◽  
Bland Altman Plot ◽  
Consecutive Sampling ◽  
Arterial Blood

Pasien dengan ventilasi mekanik perlu dilakukan pemantauan CO2 karena berperan penting pada regulasi pernapasan dan keseimbangan asam-basa tubuh. Pemantauan CO2 dapat dilakukan dengan mengukur PaCO2 melalui analisis gas darah arteri. Pengukuran PaCO2 tidak dapat dilakukan secara kontinu sehingga perlu sering dilakukan pengambilan darah arteri yang dapat menimbulkan komplikasi. Pengukuran PETCO2 dapat memantau CO2 secara kontinu dan non invasif. PETCO2 adalah tekanan parsial CO2 ekspirasi yang diukur pada saat akhir volume tidal pernapasan. Penelitian ini bertujuan membandingkan nilai PETCO2 dan PaCO2 pada pasien dengan ventilasi mekanik di ruang GICU RSUP Dr. Hasan Sadikin Bandung. Rancangan penelitian yang digunakan adalah prospective cross sectional. Pemilihan sampel dilakukan secara consecutive sampling. Penelitian dilakukan terhadap 21 pasien yang menggunakan ventilasi mekanik di ruang GICU RSUP Dr. Hasan Sadikin Bandung. Data PETCO2 dicatat pada saat perawat mengambil sampel darah arteri untuk pemeriksaan analisis gas darah. Didapatkan 122 pasang data nilai PETCO2 dan PaCO2. Data yang diperoleh dianalisis dengan Bland-Altman plot. Hasil penelitian nilai PETCO2 berada pada rentang 14-67 mmHg dan nilai PaCO2 berada pada rentang 17-77 mmHg. Bias nilai PETCO2 dan PaCO2 adalah -4,6475 mmHg lebih rendah daripada estimasi nilai bias ±5 mmHg sehingga bisa diterima secara klinik. Presisi nilai PETCO2 adalah 12,7969 mmHg (limit of agreement= 1,7509; -11,0460) lebih tinggi daripada estimasi nilai presisi ±5 mmHg sehingga tidak bisa diterima secara klinik. Kesimpulan dari penelitian ini adalah pengukuran PETCO2 tidak dapat menggantikan pengukuran PaCO2, tetapi pengukuran PETCO2 dapat digunakan untuk memperkirakan nilai PaCO2 pasien dengan ventilasi mekanik.Kata kunci: PETCO2, PaCO2, ventilasi mekanik. Comparison of PETCO2 and PACO2 Values in Patients with Mechanical VentilationAbstractPatients with mechanical ventilation need to be monitored for the CO2 value because it has an important role in regulation of respiration and body acid-base equilibrium. Monitoring of CO2 can be done by measuring PaCO2 through arterial blood gas analysis. Measurement of PaCO2 could not be done continuously so that the arterial blood are needed to be taken quite often which could cause complication. The measurement of PETCO2 can monitor the CO2 continuously and non-invasively. PETCO2 is partial pressure of CO2 expiration that is measured at the end of respiration tidal volume. This study aimed to compare the PETCO2 value and PaCO2 in patients with mechanical ventilation in GICU Dr. Hasan Sadikin Hospital. The research design was prospective cross-sectional using consecutive sampling method. The total sample was 21 patients who used mechanical ventilator in GICU Dr. Hasan Sadikin Hospital Bandung. The PETCO2 data were recorded when the patients’ arterial blood sample were taken for blood gas analysis test. The total of 122 pair date of PETCO2 and PaCO2 values were recorded. The data were analyzed using Bland-Altman plot. The results showed that the PETCO2 value ranged from 14 – 67 mmHg and the PaCO2 values ranged from 17 – 77 mmHg. The deviation of PETCO2 and PaCo2 was -4.6475 mmHg, which is lower than the estimation of ± 5 mmHg deviation, therefore the PETCO2 measurement can be accepted clinically. The precision of PETCO2 was 12.7969 mmHg (limit of agreement = 1.7509; -11.0460) which is higher than the estimation of precision value of ±5 mmHg, therefore it cannot be accepted clinically. In conclusion, the PETCO2 measurement could not replace the PaCO2 measurement, however, PETCO2 measurement can be used to predict the value of PaCO2 for patients with mechanical ventilation.Keywords: Mechanical ventilation, PETCO2, PaCO2.

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