Abstract
Statement of Problem
There is a lack of information regarding outcomes on neonates born premature who require medical management using high-frequency jet ventilation for respiratory distress syndrome that is unresponsive to conventional mechanical ventilation.
Sources of Data
This study employed a retrospective, comparative, correlational design utilizing data previously collected by a Special Care Nursery at a northern California tertiary hospital. The population consisted of 117 neonates born at less than 32 weeks gestation and weighing less than 1,500 grams. Data were collected between January 2006 and December 2006 to determine if neonates managed on high-frequency jet ventilation had a higher incidence of intraventricular hemorrhage than neonates managed on conventional mechanical ventilation only or required no mechanical ventilation. This study also sought to determine what relationship intraventricular hemorrhage has to extraneous variables, such as hypotension requiring inotropic medications, hypoglycemia, low apgar scores at birth, low birth weights, gestational age, anesthesia, anemia, sepsis, no prenatal care, infants born from diabetic mothers, infants with heart disease, infants with chronic lung disease, apnea of prematurity, abruption, thrombocytopenia, drug exposure, multiple birth, pulmonary hypertension, cor pulmonale, air leak, metabolic acidosis, and transport from another facility.
Conclusions
The data revealed a significant correlation in infants that developed intraventricular hemorrhage that were also treated with high-frequency jet ventilation (p = 0.032), had apgar scores less than five at one minute after birth (p = 0.017), and required inotropic medications for hypotension (p = 0.011). The conclusion was inconclusive. It was difficult to ascertain which variable contributed to intraventricular hemorrhage: high-frequency jet ventilation, birth asphyxia at one minute after birth, or hypotension requiring inotropic medications.