Estimation of recruitment maneuver efficiency in premature infants with respiratory distress syndrome

• Aleksandrovich Yuriy S.
• O.A. Pechueva
• Pshenisnov Konstantin V.
• Khienas V.

Abstract

The respiratory distress syndrome of newborns is one of the most common critical states in neonatal period. It is associated with progressing hypoxemia and requires high-invasive methods of respiratory support. Along with surfactant replacement therapy alveolar recruitment maneuver is the most promising and pathogenetically reasonable strategy of respiratory stabilization in premature infants. This technique of respiratory therapy is widely used in adults now, while safety and clinical efficiency of recruitment maneuver for neonatal resuscitation still needs to be proved.

Aim of the work was to study the efficacy of recruitment maneuver in premature infants with respiratory distress syndrome by analyzing the clinical and laboratory patient statuses and the disease outcomes in early and long-term periods and also to define the optimal time for the maneuver application.

Material and methods: our study enrolled 51 premature infants with clinical manifestations of respiratory distress syndrome. The average birth weight was 1343 (±125) grams. In 24 newborns (group 1) the respiratory distress was accompanied by expressed hypoxemia which was the indication to perform the recruitment maneuver (alveoli opening). In order to evaluate the recruitment maneuvers efficacy in long-term outcome 27 newborns with similar clinical presentation and provided therapy, but without the recruitment maneuver, were also included in our research.

Results. It is found that the recruitment maneuver provided to premature infants with respiratory distress syndrome significantly improves blood oxygenation and mechanical characteristics of lungs. It is shown that the optimal time to perform the recruitment maneuver is the second or third day of life.

Conclusion. Alveolar recruitment maneuver has high clinical efficacy in premature infants with RDSN. It promotes fast and significant decrease in lungs ventilation parameters and reduction of numerous complications of the main disease.

Keywords:alveolar mobilization maneuver, recruitment, respiratory distress syndrome, newborn

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