Wpływ podwyższenia wartości dodatniego ciśnienia w drogach oddechowych, podczas stosowania metody CPAP u noworodków z niewydolnością oddechową, na parametry układu krążenia i wymiany gazowej
© Borgis - Nowa Pediatria 3/2013, s. 84-90
*Marta Sobczyk
Summary
Introduction. Optimal value of pressure requires taking into account circulation and respiratory parameters.
Aim. This paper investigates the influence of growth values of positive pressure from 4 to 6 cm H2O on the PaO2, SpO2, PaCO2, pulse, mean artery blood pressure, blood flow velocity in a pulmonary artery, gradient pressure through the pulmonary valve, pulmonary artery acceleration time, right ventricular output and ejection fraction of the left ventricle.
Material and methods. The parameters mentioned were analysed twice: during the ventilation with pressure 4 cm H2O and after 30 minutes of with pressure 6 cm H2O. This was applied to 40 newborns.
Results. Among all the children the increase of the positive pressure did not cause an important change in pulse saturation: p1 = 0.2796, p2 = 0.2334; the value of pulse: p1 = 0.1504, p2 = 0.2257; the mean artery pressure: p1 = 0.1490, p2 = 0.2056; the partial pressure of oxygen: p1 = 0.6237, p2 = 0.6417; the value of acceleration time: p1 = 0.1949, p2 = 0.1167; the LV ejection fraction: p1 = 0.4658, p2 = 4681; and the right ventricular output: p1 = 0.3261, p2 = 0.2623. Non-significant decrease of the blood flow velocity in the pulmonary artery took place: p1 = 0.0483, p2 = 0.0205 and the gradient pressure through the pulmonary artery valve p1 = 0.0697, p2 = 0.0374.
Conclusions. It was detected that additional pathological changes of lungs can be a contraindication for the increase of the positive pressure. During the treatment with positive pressure changes in lungs’ and intracardiac circulation should be observed. Change in the parameters analysed by 25% in relation to the initial value may have clinical importance.
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