tailieunhanh - báo cáo khoa học: "Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report | Mann and Bar Journal of Medical Case Reports 2011 5 435 http content 5 1 435 JOURNALOF medical case reports CASE REPORT Open Access Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation a case report Christian Mann1 2 and Walter Bar1 2 Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100 oxygen with a flow of L minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O with pressure support of 4 cmH2O trigger at mL second and a maximum inspiratory time of seconds. Over the course of seven weeks the patient s maximum daytime fraction of inspired oxygen via nasal cannula decreased from to his respiratory rate from 64 breaths minute to 50 breaths minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy. Introduction Although there is some evidence that nasal noninvasive ventilation has the potential to reduce the incidence of bronchopulmonary dysplasia BPD in preterm newborns 1-5 there have been no studies of nasal nonin-vasive positive pressure ventilation NIPPV in former preterm infants with an established diagnosis of BPD requiring high oxygen concentrations. The main .