Changes in dead space/tidal volume ratio and pulmonary mechanics after surfactant replacement therapy in respiratory distress syndrome of the newborninfants

Citation
Eh. Chung et al., Changes in dead space/tidal volume ratio and pulmonary mechanics after surfactant replacement therapy in respiratory distress syndrome of the newborninfants, J KOR MED S, 16(1), 2001, pp. 51-56
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
JOURNAL OF KOREAN MEDICAL SCIENCE
ISSN journal
1011-8934 → ACNP
Volume
16
Issue
1
Year of publication
2001
Pages
51 - 56
Database
ISI
SICI code
1011-8934(200102)16:1<51:CIDSVR>2.0.ZU;2-H
Abstract
This study was performed to elucidate the mechanism of improved oxygenation after surfactant replacement therapy in respiratory distress syndrome (RDS ) of the newborn infants. In 26 newborns with RDS, end tidal-CO2 tension (P etCO(2)), arterial blood gas analysis and pulmonary function tests were mea sured at baseline, 30 min, 2 hr and 6 hr after surfactant administration. T he changes in dead space/tidal volume ratio (V-D/V-T ratio=(PaCO2-PetCO(2)) /PaCO2), oxygenation index and arterial-alveolar partial pressure differenc e for oxygen ((A-a)DO2) were elucidated and correlated with pulmonary mecha nics. Oxygenation index and (A-a)DO2 improved, and V-D/V-T ratio decreased progressively after surfactant administration, becoming significantly diffe rent from the baseline at 30 min and thereafter with administration of surf actant. Pulmonary mechanics did not change significantly during the observa tion period. V-D/V-T ratio showed close correlation with OI and (A-a)DO2, b ut not with pulmonary mechanics. These results suggest that decreased physi ologic dead space resulting from the recruitment of atelectatic alveoli rat her than improvement in pulmonary mechanics is primarily responsible for th e improved oxygenation after surfactant therapy in the RDS of newborn.