| Influences of the Intrapulmonary R→L Shunt on PaO2 and PaCO2 after Instillation of Exogenous Pulmonary Surfactant to Premature Neonates with Respiratory Distress Syndrome |
|
Yoon Hyung Park, Sei Woo Chung, Seung Baik Han, Young Se Kwon, Ji Youn Kim, Woo Sik Cheong, Dae Hyun Lim, Byong Kwan Son |
|
Department of Pediatrics, InHa University Hospital, Seongnam, Korea |
| 미숙아 호흡곤란 증후군에서 인공 폐 표면활성제 투여 후 폐 내 우→좌 단락이 PaO2와 PaCO2에 미치는 영향 |
|
박윤형, 정세우, 한승백, 권영세, 김지연, 정우식, 임대현, 손병관 |
|
인하대학교 의과대학 소아과학교실 |
|
|
|
|
| Abstract |
Purpose
: We are inclined to analyze the relationship between the intrapulmonary
right-to-left shunt and the PaO2/PaCO2 after endotracheal single-dose surfactant instillation
to premature neonates with respiratory distress syndrome within 6 hours after
birth.
Methods
: From Jan. 1993 to Jun. 1995, we have conducted a clinical trial of surfactant
replacement therapy to the premature neonates with respiratory distress syndrome at
the neonatal intensive care unit of InHa University Hospital. The surfactant group(n=17)
was given Surfactant-TA and mechanical ventilator care, but the control group(n=22)
was treated with only mechanical ventilator. We analyzed umbilical arterial blood gases
and estimated respiratoy indexes before and after treatment.
Results
:
1) The QSP/QT decreased initially in the surfactant group, but significantly increased 24
hours after treatment in the control group(40.6¡¾4.7%, P < 0.05).
2) The PaO2 significantly decreased 2 hours and 24 hours after treatment in the
control group(60.8¡¾10.1mmHg, 63.5¡¾7.6mmHg, P < 0.05 respectively).
There were significant correlations between the QSP/QT and the PaO2 in both groups,
and specifically in the conrol group 24 hours after treatment(r=-0.94, P < 0.001).
3) The PaCO2 significantly increased 1 hour after treatment, but significantly decreased
specifically in the control group 24 hours after treatment(32.5¡¾1.8mmHg, P < 0.01).
However, there were no signifacnt correlations between the QSP/QT and the PaCO2 in
both groups.
Conclusions
: Specifically in the control group 24 hours after treatment, with hypocapnia,
significant increase in pulmonary blood flow to capillary shunt and low VA/Q
units (VA/Q< 0.1) at high FIO2(> 0.5) resulted in a decrease in PaO2 and also a significant
relationship was found between the QSP/QT and the PaO2. However, there was no
significant relationship between the QSP/QT and the PaCO2. |
| Key Words:
Intrapulmonary right-to-left shunt(QSP/QT), PaO2, PaCO2, Exogenous surfactant, Respiratory distress syndrome, Hypocapnia |
|
PDF Links
Download Citation
