STRESS-RESPONSE AND MODE OF VENTILATION IN PRETERM INFANTS

Citation
Mw. Quinn et al., STRESS-RESPONSE AND MODE OF VENTILATION IN PRETERM INFANTS, Archives of Disease in Childhood, 78(3), 1998, pp. 195-198
Citations number
21
Categorie Soggetti
Pediatrics
ISSN journal
00039888
Volume
78
Issue
3
Year of publication
1998
Pages
195 - 198
Database
ISI
SICI code
0003-9888(1998)78:3<195:SAMOVI>2.0.ZU;2-X
Abstract
Aim-To assess the change in stress response in preterm babies changed from patient triggered ventilation (PTV) to conventional mandatory ven tilation (CMV) and vice versa; to determine outcome in relation to str ess hormone concentrations. Methods-A randomised controlled study was conducted in two district general hospital neonatal intensive care uni ts. Thirty babies, treated initially with CMV, were randomly assigned to remain on CMV or to change to PTV. A second group of 29 babies, tre ated initially with PTV, were randomly assigned to remain on PTV or to change to CMV. The babies were less than 32 weeks of gestation, venti lated within 72 hours of birth, with clinical and radiological feature s compatible with respiratory distress syndrome (RDS). Stress hormone concentrations and clinical distress score were measured before and 20 minutes after allocation of mode of ventilation. Results-Babies chang ed from CMV to PTV had significantly reduced adrenaline concentrations (median change -0.4 nmol/l) compared with those who remained on CMV. There was no increase in adrenaline in babies changed from PTV to CMV. There were no significant changes in noradrenaline concentrations or clinical distress score. Babies who died had significantly higher adre naline and noradrenaline concentrations than those who survived. Concl usion-A change in mode of ventilation significantly reduces adrenaline concentrations. Raised catecholamine values are associated with a poo r outcome.