Treatment Of Neonatal Respiratory Failure By Ventilator

Objective: To evaluate the effects of mechanical ventilation and other life-support procedures on neonatal respiratory failure, and to analyze corresponding complications and related high risk factors.Methods: Eighty-six neonates with respiratory failure were treated by ventilator in our NICU from July 2002 to December 2004. The application of ventilator and related remedies was explored. The differences of perinatal risk factors, temperature, ventilator parameters, incidence of ventilator associated pneumonia, use of surfactant, parenteral nutrition and mucosolvan were compared.Results: 1.The percentage of curing of critical newborn by ventilator was 71%, and the most common complication was ventilator associated pneumonia(VAP) with an incidence 30.2%. The most familiar bacterium were klebsiella pneumoniae and pseudomonoas. 2.There was no significant difference(P>0.05) in Apgar Score at 5 min, initial parameters of ventilator between the cured group and the uncured group of HMD, nor was FiO2, respiratory rate(RR), positive end-expiratory pressure(PEEP), time of inspiration(Ti) among the highest parameters. But the significant difference of the two groups was observed in gestational age, birth weight, fetal hypoxia, Apgar Score at 1 min, peak inspiratory pressure(PIP) of the highest parameter, complication with VAP, the use of surfactant, parenteral nutrition and mucosolvan(P<0.05). 3. PIP, FiO2 and duration of FiO2 among the highest parameters in surfactant treatment group of HMD were significantly lower than that of non surfactant treatment group(P<0.05). The frequency of aspirating sputum in mucosolvan treatment group of HMD was significantly less than non mucosolvan treatment group(P<0.05).Conclusions: Assisted mechanical ventilation is an important procedure in the treatment of neonatal respiratory failure. Reinforing the prognostic of perinatal high risk fators, timely prevention and treatment of complication, proper using of respirator, combined with the use of surfactant, parenteral nutrition and mucosolvan can improve the percentage of curing of respiratory failure.