IMPROVEMENT OF THE OXYGENATION IN SEVERE HYPOXEMIC NEWBORNS TREATED WITH ENDOTRACHEAL INHALATORY SODIUM NITROPRUSSIDE. 2050

Abstract

6 newborns admitted in the NICU with severe hypoxia, BW: 2553 ± 253 g, 4 PT infants (33,75 wks GA) and 2 term infants and submitted to mechamical ventilatory support with PIP ≥ 26 mmHg; FIO2 = 100%, RR ≥ 40 mpm and even with a condition of hypoxia which measured PaO2 = 28,85 mmHg and SaO2 = 35,56%, were treated by means of a specific adapter conceived by us, endotracheal inhalatory sodium nitroprusside (SNP) was continuously inhaled (25mg%) with a flow between 2-4 liters/minute. With a mixer attached to an adapter (blender), it was possible to mantain the same FiO2 of the respirator. One hour after beginning the inhalation of the SNP, the mean of the PaO2 and mean SaO2 presented improvement, respectively: 69,80 mmHg and 90,86% and the medium of the BP = 74,16 mmHg was similar to that previous of the treatment 75,16 mmHg Also, between 6-8 hs and with 24 hours of treatment, the medium of the PaO2 and the SaO2 maintained with increase, respectively; PaO2 = 74,23 mmHg and 90,73 mmHg and SaO2 = 94,75% and 94,43% and the mean of the medium BP was normal: 82,33 mmHg and 82,33 mmHg. The major proof of the efficiency of the inhalation of the endotracheal SNP solution was that when the solution had finished in the adapter, the oxygen saturation monitor showed a drop of the SaO2 in a few minutes. The medium time of the treatment was between 4-6 days, but one baby died after the treatment by sepsis and the other five were discharged from the hospital in good condition. New studies are necessary, principally concerning collateral effects and standardization of dosage.