High frequency oscillatory ventilation combined with inhaled nitric oxide on neonates with severe meconium aspiration syndrome

Abstract

Objective To investigate the effects of high frequency oscillatory ventilation (HFOV)combined with inhaled nitric oxide(iNO) on neonates with severe meconium aspiration syndrome(MAS).Methods Sixty newborn infants with severe MAS admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Oct 2008 to May 2011 were included for this study.All of them needed mechanical ventilation after birth and oxygenation index (OI) ＞ 30.According to the different ventilation modes,they were randomly divided into conventional mechanical ventilation (CMV) group,HFOV group and HFOV combined with iNO (HFOV + iNO) group,each group had twenty neonates.OI and the rate of air leak and pulmonary hypertension in each group were compared.Results Ventilation after 24 h,OI of HFOV group and HFOV + iNO group were significantly decreased as compared with CMV group (19.0 ± 4.5 vs 11.0 ± 5.3 vs 25.0 ± 7.1,P ＜ 0.05).In HFOV + iNO group,the obvious decline of OI(from 36.0 ± 7.4 to 24.0 ± 5.2) were observed at four hours after treatment.The rate of air leak in HFOV and HFOV + iNO groups was both zero as compared with CMV (5/20,25％).The rate of pulmonary hypertension in HFOV + iNO group was zero and the HFOV group was 30％ (6/20),the CMV group was 40％ (8/20).Conclusion HFOV combined with iNO was preferred treatment for neonates with severe MAS,and they have synergistic effect. Key words: High frequency oscillatory ventilation; Nitric oxide; Meconium aspiration syndrome; Mechanical ventilation ; Children