Flovent Inhaler

- Pulmonary Sequelae at Six Months following Extracorporeal Membrane Oxygenation (7)

Pulmonary Sequelae at Six Months following Extracorporeal Membrane Oxygenation (7)Prior to ECMO all infants demonstrated severe gas exchange abnormalities, with the mean lowest Pa02 being 32 ±3 mm Hg while on maximal mechanical ventilator settings such as FIo2 of 1.0 and the MAP being 18.7 +1.2 cm H20 (Table 1). One infant had cardiac arrest requiring resuscitation prior to ECMO. The mean highest OI was 79 ±20, and therefore all study subjects met the institutional criteria of a greater than 80 percent mortality on conventional therapy (OI >40) prior to ECMO.
The primary pediatrician taking care of the infant, from the time of discharge from NICU until 6 months of age, treated these infants with supplemental oxygen, diuretics and/or bronchodilators if necessary based on clinical signs and symptoms (elevated respiratory rate, rales, noninvasive oxygen and carbon dioxide monitoring and arterial blood gas levels). At 6 months of age, 10 out of 19 of these infants, or 52 percent, were still being treated with aerosolized ($2 agonist bronchodilators, and 6 (32 percent) were being treated with oral diuretics (Diuril and Dyrenium). Four infants (21 percent) received diuretics and bronchodilators.

Table 1 – Clinical and Demographic Data of Study Infants

No. of infants 19
Gestational age at birth (weeks) 39.8 ±0.5
Birth weight (kg) 3.3±0.1
Study weight (kg) 6.9 ±0.2
OI 79 ±20
FIo2 1.0±0
MAP (cm HaO) 18.7± 1.2
Last Pa02 before ECMO (mm Hg) 32 ±3
Pa02 – Pa02 (mm Hg) 636 ±3
PilOa/PAO* 0.05 ±0.01
Age at starting ECMO (h) 43.4 ±9.1
Duration of ECMO (h) 91 ±11
Duration of assisted mechanical ventilation after ECMO (h) 212 ±44
August 11, 2013 Pulmonary function
Tags: chronic lung disease mechanical ventilation neonatal respiratory failure pulmonary function respiratory failure