PREOPERATIVE MANAGEMENT OF CONGESTIVE-HEART-FAILURE IN NEONATES - THECLOSED HOOD

In this study we report the results of the use of a closed hood with n o external administration of CO2 to increase pulmonary vascular resist ance by lowering the inspired fraction of oxygen (FiO(2)) and raising the inspired fraction of carbon dioxide (FiCO(2)) in patients with con genital heart disease and increased pulmonary blood flow. Between Dece mber 1995 and May 1996, 9 neonates (F:5, M:4) were admitted. Each stud y patient was assigned to clinical classes using a 1 to 4 classificati on. Ages ranged between 2 and 30 days (mean 18), weight between 2.25 a nd 3.65 kg (mean 2.89). A plastic hood, closed on the top with a plast ic membrane and with the gas entrance open to room air was placed over the head of the patients. Patients increase pCO(2) by rebreathing the ir own expired CO2. After 24 h of the onset of the treatment the media of points of congestive heart failure 1 to 4 classification decrease from a mean of 4 to a mean of 2.28 +/- 0.44 (p = 0.001). A statistical ly significant improvement in symptoms and lowering of pO(2) and pH wh ile raising pCO(2) has been demonstrated in this study. (C) 1997 Elsev ier Science Ireland Ltd.