New method of diagnosis and treatment of respiratory disorders in neonates

Abstract

Objective: To investigate the possibility of using capnography for pre-clinical diagnostics of pathophysiological mechanisms of respiratory disorders.

Full Text

Methods: We assessed peculiarities of capnogram (C) in 35 neonates with gestational age 32 — 34 weeks (n=15), 35 — 37 weeks (n=16) and 38-40 weeks (n=4) with respiratory disorders during the first 2-3 hours of life. The data were analyzed taking into account functional state of central nervous system (CNS) and cardio-vascular system.

Results: We distinguished 3 types of C. depending on the presence of alveolar plateau: alveolar plateau is present (1), alveolar plateau is absent (2) and alveolar plateau is interrupted by sighs (3). There percentage was changed, particularly increasing of 2 type reflects functional disorders of CNS. End-tidal concentration of CO₂ reflects disorders of lung function due to alveolar ventilation (CO₂> 5,0 vol%), lung hemodynamics (C0₂< 4,0 vol%) or both (CO₂< 3,2 vol%). Individual choosing of oxygen therapy using these data helps to decrease severity of respiratory disorders.

Conclusion: Monitoring of C should be used for assessment of severity and main pathophysiological mechanism of respiratory disorders for optimization of respiratory therapy in neonates.