Dynamic change in respiratory mechanic dynamics and its clinical significance during mechanical ventilation in hyaline membrane disease of children

Objective To explore the characteristics of changes in respiratory mechanic dynamics and clinical significance in hyaline membrane disease (HMD) under mechanical ventilation. Methods One hundred and twenty-six newborns with HMD undergoing mechanical ventilation were divided into two groups: complication group with 43 cases and no-complication group with 83 cases. The blood gases and indices of respiratory mechanic dynamics were monitored 2, 24, 48 and 72 hours after the first ventilation and before the first weaning from ventilation. Results Pulmonary compliance 〔(0.55± 0.10) ml·cm H2O~ -1·kg~ -1, (0.43±0.10) ml·cm H2O~ -1·kg~ -1〕 and minute volume 〔MV, (0.65± 0.10) L/min, (0.62±0.30) L/min〕 were elevated compared with that after ventilation for 2-72 hours, however the oxygenation index 〔OI, (10.2±1.9)mm Hg vs. (13.6±4.3) mm Hg〕 significantly lower. The compliance and MV in no-complication group were higher than that in complication group 24 and 48 hours after ventilation. There were no differences in the airway resistance and lung inflation index between two groups. The pulmonary compliance was negatively correlated with OI (r=-0.208, P0.01) and corrected with MV (r=0.218, P0.01). In no-complication group, all cases ventilation was weaned successfully at once in all the patients,and their mean compliance and MV were (0.55±0.10) ml·cm H2O~ -1·kg~ -1 and (0.65±0.20) L/min respectively. However, in complication group, weaning failed 38 patients, their mean compliance and MV were (1.03±0.30) ml·cm H2O~ -1·kg~ -1 and (0.33±0.30) L/min respectively. Conclusion Respiratory mechanic dynamics monitoring is beneficial in evaluating the severity of hyaline membrane disease and complications, guiding mechanical ventilation management and weaning.