Abstract
The aim of the research. To study the effect of invasive and non-invasive lung ventilation in full-term infants with moderate and severe HIE on cerebral perfusion and central hemodynamics.Materials and methods To study the effect of non – invasive lung ventilation on central hemodynamics and cerebral perfusion, 60 infants with moderate and severe YIE were examined, thirty of them had early tracheal extubation 72 hours after birth and were transferred to non–invasive nasal lung ventilation with intermittent positive pressure (NIPPV), another 30 new-borns formed a comparison group. They had a traditional MV.Results No differences were found between the mean blood pressure and heart rate in the newborn core and comparison group, both during the first day of stay and during the fourth day, when the core group infants were extubated and transferred to NIPPV, but the mean BP level increased significantly after the core group infants were transferred to NIPPV, compared to the values of this indicator during the first day (p<0.05).The study of central hemodynamics indices in the new-born infants of the main group within a day after extubation and transfer to NIPPV did not reveal any differences in comparison with the new-born comparison groups. Stroke volume, heart index and left ventricular ejection fraction did not differ in the main group and comparison group.When studying the effect of non-invasive lung ventilation on brain perfusion, no reliable differences between the study groups were also found.Conclusions. No statistical difference was found between НI and EF in the main group and the comparison group, respectively. Non-invasive ventilation in NIPPV mode does not affect cerebral perfusion indices compared to conventional ventilation NIPPV and can be used in intensive care of new-borns with HIE
Highlights
Hypoxic-ischemic encephalopathy (HIE) remains one of the most important medical and social problems of modern neonatology and neonatal intensive care, because it is due to these patients that the number of children with disabilities is increasing
Materials and methods A prospective, cohort, randomized study was conducted in which 60 (100.0 %) infants born between 38 and 42 weeks of gestation were treated in the Department of Anesthesiology and Neonatal Intensive Care (DANIC) of the Municipal Non-Commercial Enterprise
Surkov and co-authors (2014) in their prospective, observational, multicenter, longitudinal, cohort study, which studied the effect of respiratory support and its parameters on cerebral perfusion and central hemodynamics in newborns with severe and moderate HIE, concluded that types of artificial ventilation (AV) do not affect cerebral perfusion
Summary
Hypoxic-ischemic encephalopathy (HIE) remains one of the most important medical and social problems of modern neonatology and neonatal intensive care, because it is due to these patients that the number of children with disabilities is increasing. The frequency of this pathology is 2–3 cases per 1000 full-term new-borns in developed countries and up to 26 cases per 1000 full-term newborns – in underdeveloped countries [1]. The main, effective way to improve the results of treatment of children with HIE – is the procedure of therapeutic hypothermia [1]. Despite numerous evidences of harmful effects of hypocapnia, it is difficult to achieve normocapnia in these patients [10, 11]
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