CONTINUOUS NEGATIVE CHEST WALL PRESSURE IN HYALINE MEMBRANE DISEASE: ONE YEAR EXPERIENCE

Abstract

Application of a continuous positive transpulmonary pressure by producing a continuous negative chest wall pressure (CNP) was utilized in the treatment of 49 infants with severe hyaline membrane disease (HMD). In 23 infants in whom spontaneous alveolar ventilation was adequate, CNP was associated with an average elevation in arterial Po2 of over 40 mm Hg while inspired oxygen concentration remained unchanged. Alveolar-arterial O2 tension difference (A-aDo2) decreased significantly. All of these infants survived. In 26 infants with severe alveolar hypoventilation, CNP was used in conjunction with artificial ventilation. Arterial Po2 increased significantly and A-aDo2 decreased. Twelve of these infants survived (46%). The overall survival rate was 71.5%. CNP appears to be an important adjunct to the therapy of severe HMD.