Effect of non–invasive ventilation on central and brain hemodynamics in term newborn infants with hypoxic – ischemic encephalopathy

E. Klevakina, I. Anikin, O. Mykhalchuk
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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
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无创通气对缺氧缺血性脑病足月新生儿中央及脑血流动力学的影响
研究的目的。探讨有创与无创肺通气对中重度HIE足月儿脑灌注及中央血流动力学的影响。材料与方法为研究无创肺通气对中重度新生儿脑血流动力学和脑灌注的影响,对60例新生儿进行检查,其中30例在出生后72 h早期拔管,转入无创鼻肺间歇正压通气(NIPPV),另30例作为对照组。他们有一个传统的MV。结果新生儿核心组与对照组在住院第1天及核心组拔管转入NIPPV后第4天的平均血压和心率均无差异,但核心组转入NIPPV后的平均血压水平较第1天的血压和心率明显升高(p<0.05)。主组新生儿拔管转入NIPPV后1天内的中心血流动力学指标与新生儿对照组比较无差异。主要组和对照组的脑卒中容量、心脏指数和左室射血分数无显著差异。在研究无创肺通气对脑灌注的影响时,也没有发现研究组之间的可靠差异。主组与对照组НI与EF无统计学差异。与常规通气NIPPV相比,NIPPV模式下无创通气不影响脑灌注指标,可用于新生儿HIE重症监护
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审稿时长
6 weeks
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