Background:Pulmonary disease is still the main reason cause diseases and mortality for preterm babies. Objectives:This study aims to evaluate of the clinical efficacy of high-frequency oscillatory ventilation in the treatment of preterm infants who have seriously respiratory distress syndrome required mechanical ventilation. Subjects and method:A prospective clinical trail was conducted at Neonatal Unit of Tu Du Hospital from 1st December 2005 to 30th November 2006. Intervention: Patients were randomized to high-frequency oscillatory ventilation (20 patients) or conventional mechanical ventilation-CMV (59 patients). High-frequency oscillatory ventilation(HFOV) was used in high lung volume strategy. Results:The two groups of patients were similar in demographic distribution of birth weight, gestational age, gender, surfactant after birth. Patients on HFOV were ventilator \ufffd?dependent (2.14 \xb1 1.76 vs 3.48 \xb1 2.70 day. p=0.004) and respiratory pressure support (4.01 \xb1 2.23 vs 6.55 \xb1 day. p =0.02) for a shorter time than patients on CMV. Conclusion: First intention HFOV with high volume strategy shortened the time of ventilation and pressure support in preterm infants with seriously respiratory distress syndrome. In the future, it will be necessary to have the tremendous research for the efficacy of HFOV in order to decrease the ratio of bronchopulmonary dysplasia of infants who have seriously respiratory distress syndrome required mechanical ventilation.
Respiratory Distress Syndrome ; Newborn/ therapy ; Infant ; Premature

Neonatal coagulation disorders and thromboembolism require timely management. Failure to treat these conditions at the appropriate time may lead to death or the development of significant long-term sequelae. However, most current guidelines for managing neonatal coagulation disorders and thromboembolism are empiric and not based on randomized clinical trials. Thus, it is not easy to choose an appropriate management strategy for these conditions in clinical settings. In this review, therapeutic guidelines currently utilized in clinics and novel therapeutic options still under investigation are presented and reviewed.
Humans ; Infant, Newborn ; Thromboembolism ; Thrombolytic Therapy

Humans ; Infant, Newborn ; Spasms, Infantile ; diagnosis ; therapy

Humans ; Infant, Newborn ; Jaundice, Neonatal ; diagnosis ; therapy

Bronchopulmonary Dysplasia ; therapy ; Humans ; Infant, Newborn

Atrioventricular Block/therapy* ; Autoantibodies ; Humans ; Infant, Newborn

Female ; Hemangioma ; therapy ; Humans ; Infant, Newborn ; Syndrome ; Thrombocytopenia ; therapy

Humans ; Infant, Newborn ; Cell- and Tissue-Based Therapy ; Infant, Newborn, Diseases/therapy*

Acute Disease ; Fatal Outcome ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Respiratory Distress Syndrome, Newborn ; diagnosis ; therapy

OBJECTIVETo assess the efficacy of nasal intermittent positive pressure ventilation (NIPPV) in treatment of respiratory distress syndrome (RDS) in premature infants.

METHODSAccording to the requirements of Cochrane systematic review, a thorough literature search was performed among PubMed (1977-2008), Embase (1989-2008), OVID, Cochrane (2008), Chinese Digital Hospital Library (www.chkd.cnki.net) and Chinese Biomedical Literature Disk Database (CBMdisc). Quality assessments of clinical trials were carried out. Randomized controlled trials (RCTs) with NIPPV and RDS were enrolled, and Revman 4.2 software was used for meta-analysis. The trials were analyzed using relative risk (RR) for dichotomous data, weighted mean difference (WMD) were used for continuous data, both kind of data were expressed by 95% confidence intervals (95% CI). For homogenous data (P> or =0.10), fixed effects model was calculated, for heterogeneity data (P<0.10), random effects model was calculated.

RESULTSFive RCTs involving 284 premature infants diagnosed as respiratory distress syndrome (RDS) were included. Three studies comparing NIPPV with nasal continuous positive airway pressure (NCPAP) in the postextubation period, the extubation failure rate was 8.34% vs 40.79% in NIPPV group and NCPAP group, the NIPPV group had significantly lower extubation failure rates [RR 0.21 (95% CI: 0.10-0.45; P<0.001)]. Two of the above-mentioned three studies analyzed bronchopulmonary dysplasia (BPD) rates, the incidence of BPD was 39.34% vs 54.39% in NIPPV group and NCPAP group, the NIPPV group had a trend towards lower BPD rates, but this did not reach statistical significance [RR 0.73 (95% CI: 0.49-1.07; P=0.11)]. NIPPV was used as primary mode in two studies, one compared with conventional ventilation (CV), which detected that the NIPPV group had significantly lower BPD rates (10% vs. 33.33%, P=0.04); the other compared with NCPAP, which also showed that NIPPV group had significantly lower BPD rates (2.33% vs. 17.07%, P=0.03).

CONCLUSIONThe primary mode NIPPV was found to be feasible as a method of ventilation in preterm infants with RDS, and was associated with a decreased incidence of BPD. In the postextubation period, NIPPV is more effective in preventing failure of extubation than NCPAP.