Article Text

DEEP AND MILD HYPOTHERMIA: ARE THERE DIFFERENCES IN VENTILATOR PARAMETERS?
  1. G Cavallaro1,
  2. E Agazzani1,
  3. L Andaloro1,
  4. S Boccacci1,
  5. C Bottura1,
  6. E Cerini1,
  7. G Cristofori1,
  8. P Mussini1,
  9. F Sacco1,
  10. A Plantulli1
  1. 1Neonatal Intensive Care Unit, Carlo Poma Hospital, Mantova, Italy

Abstract

Objective Mild hypothermia (MH) (rectal temperature 33–34 C) appears neuroprotective. Deep hypothermia (DH) (rectal temperature 30–33 C) could be a new therapeutic strategy for treating severe hypoxic-ischemic term infants. The aim of this study was to describe ventilator changes during DH and MH.

Methods 28 term asphyxiated newborns were enrolled: 20 DH and 8 MH. Mechanical ventilation was set to maintain an arterial oxygen saturation of 92–95% with PaO2 between 50 and 60 mmHg and PaCO2 between 40 and 45 mmHg.

Results 14 DH (70%) and 4 MH patients (50%) were treated with SIMV. In the DH group, 7 patients (35%) were maintained in room air and 13 (65%) required oxygen (FiO2 0.27–1.0). In MH group, 4 cases (50%) required oxygen (FiO2 0.22–1.0) and 4 (50%) room air. Mean of hours of ventilation were 48.11 (44.11) hrs in DH and 105.5 (69.69) hrs in MH; there was no statistically significant difference between the two groups (p = 0.095). Mean of hours of oxygen required were 88.5 (91.95) hrs in DH and 231 (58.298) hrs in MH (p = 0.010). There was no statistical difference in the highest quantity of FiO2 between the DH and MH (P = 0.747).

Conclusions Mild and deep hypothermia did not produce any change in mean of hours of ventilation. However there is a statistically significant difference in hours of oxygen support. This discrepancy is probably correlated to a reduction in oxygen consumption, for a decrease in metabolic state in DH group compared with MH group.

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