Manual high-frequency continuous positive airway pressure on the neonatal transport of severe meconium aspiration syndrome

Abstract

Objective To explore the clinic application of manual high-frequency continuous positive airway pressure(CPAP) treatment with self-inflating bags (SIB) fitted with PEEP valves on the neonatal transport of severe meconium aspiration syndrome(MAS). Methods On the basis of bronchial alveolar lavage, correction of acidosis and circulation support, 52 neonates with severe MAS were treated with SIB+ PEEP valves which were used for manual high-frequency CPAP during the transfer.The conditions, complications, blood gas before and after treatment, and prognosis were monitored and analyzed. Results Fifty-two cases of MAS were transported successfully, and without any deterioration in transit condition, additional air leak, and sustained pulmonary hypertension occured.The blood gas of pH, PaO2, PaCO2, PaO2/FiO2 were improved at each time point, the differences were statistically significant (P<0.01). Three neonates(5.77%, 3/52) had persistent pulmonary hypertension before the treatment and were improved on the treatment with magnesium sulfate.Forty-eight cases(92.31%, 48/52)were cured, and improved in 4 cases(7.69%, 4/52)were associated with chronic lung disease, but follow-up to 6 months after birth to normal. Conclusion The method of manual high-frequency CPAP to transport the MAS neonate is reliable and effective, easy to promote. Key words: High frequency continuous positive airway pressure; Self-inflating bags; Positive end expiratory pressure; Transport; Severe meconium aspiration syndrome