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KMID : 0191119980130050495
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Journal of Korean Medical Science
1998 Volume.13 No. 5 p.495 ~ p.499
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Massive pulmonary hemorrhage in newborn infants successfully treated with high frequency oscillatory ventilation
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Ko SY
Chang YS/Park WS
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Abstract
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Massive pulmonary hemorrhage (MPH) in newborn infants is a catastrophic event with a fatal result. The aim
of this study was to assess the efficacy of high frequency oscillatory ventilation (HFOV) as a rescue
therapy for MPH in newborn infants. Eighteen newborn infants with MPH refractory to conventional mechanical
ventilation were treated with HFOV. Changes in oxygenation were assessed using arterial-alveolar oxygen
tension ratio (a/APO2) and oxygenation index (OI) during HFOV. The most common underlying disorder of MPH
was preterm patent ductus arteriosus (PDA). Thirteen out of 18 (72%) newborn infants with MPH responded to
HFOV and survived. Five out of 18 (28%) did not respond to HFOV and died. There were no differences between
responders and nonresponders in gestational age, birth weight, pre-HFOV OI, and age of MPH onset. In
responders, there was a rapid increase in a/APO2 from 0.18+/-0.04 to 0.40+/-0.08 at 30 minutes after HFOV.
There was also significant decrease in OI from 14.9+/-4.7 to 8.1+/-1.5 at 1 hour after HFOV. We conclude
that HFOV shows rapid and dramatic improvements and has ultimately life-saving effects in MPH of newborn
infants.
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KEYWORD
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