In the modern literature, unreasonably little attention is paid to the problems of long-term lung ventilation in infants who have undergone a critical condition in neonatal period. The number of such children is constantly growing due to improvement of perinatal care. Risk of long-term mechanical ventilation is higher in those newborns with multiple organ failure.

OBJECTIVE

To study the efficacy and safety of mechanical ventilation with a target inspiratory volume and downward form of flow waveform in children under prolonged mechanical ventilation after previous multiple organ failure in neonatal period.

MATERIAL AND METHODS

We analyzed 79 infants under prolonged mechanical ventilation with multiple organ failure in early neonatal period. We used SIMV-VC mode with a downward form of flow waveform. Ventilation parameters (Vt 11 (8-13) ml/kg, PIP 29 (25-32) cm H2O, PEEP 8 (7-9) cm H2O, ventilation rate 24 (20-30) inflation/min) were determined which exceed the permissible safe values. However, these parameters were well tolerated by children of this group.

RESULTS

The above-mentioned parameters of ventilation achieved after admission to intensive care unit were quite high, but they were well tolerated by the patients. Pneumothorax occurred only in 2 (2.6%) cases (p<0.05, Fisher’s test) that indicates ventilation safety. Redo intubations throughout the period of weaning from ventilator were noted in 16 (20.5%) cases (p<0.001, Fisher’s test). Mean number of repeated intubations was 1 per a patient, maximum number — 3 per a patient. Mortality was 7.6% (n=6).

CONCLUSION

The applied mode of ventilation can be considered effective for children under prolonged mechanical ventilation after previous multiple organ failure.