Effective Ventilation Mode in Early Neonatal Sepsis, Bilateral Pneumonia, and Pulmonary Hypertension in a Very Low Birth Weight Newborn (Case Report)

The aim was to demonstrate an alternative approach to respiratory therapy in respiratory failure complicated by pulmonary hypertension when conventional ventilation and high-frequency oscillatory ventilation are ineffective.

Patient and study methods. We analyzed laboratory data, ventilatory parameters and hemodynamic parameters during ventilation in a child with birth weight of 1300 grams and respiratory failure complicated by pulmonary hypertension. Dynamic selection of parameters and modes of pulmonary ventilation with transition to Airway Pressure Release Ventilation (APRV) mode is presented. Chest radiography and echocardiography were used.

Results. The use of APRV mode when traditional approaches were ineffective allowed «stabilization» of the lungs by alveolar recruitment without deep sedation and muscle relaxation. On day 20 after birth, the infant was weaned. On day 29, the infant was transferred to the neonatal pathology unit for further management, and on day 49, the infant was discharged in stable condition.

Conclusion. In neonates with severe respiratory failure, the use of the APRV mode as an alternative to ineffective conventional ventilation requires further investigation and the development of guidelines for its use.

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