Changes in mean airway pressure during HFOV influences cardiac output in neonates and infants.

Background: Changes in mean airway pressure affect cardiac output during conventional positive pressure ventilation. The effect of high-frequency oscillation ventilation (HFOV) on cardiac output is less studied.

Methods: A prospective study in a university hospital pediatric intensive care unit.

Successful EXIT (ex utero intrapartum treatment) procedure in a fetus diagnosed prenatally with congenital high-airway obstruction syndrome due to laryngeal atresia.

Congenital high-airway obstruction syndrome (CHAOS) is due to rare malformations and has been reported previously in only few cases. If the diagnosis can be made prenatally, the ex utero intrapartum treatment (EXIT) procedure may be life-saving. A healthy 28-year old nulli-para was referred because of isolated ascites found at gestational week 16 during routine ultrasound scan.

Age-dependent variations in white adipose tissue glycerol and lactate production after surgery measured by microdialysis in neonates and children.

In previous studies, we observed that lactate concentrations in interstitial white adipose tissue are higher in small infants than in adults. Moreover, no lipolysis following catecholamine challenge has been reported in neonates and small infants. Our aim was to determine with microdialysis whether the above mentioned age-dependent changes could be detected in situ after surgery.

Changes in stroke volume cause change in cardiac output in neonates and infants when mean airway pressure is altered.

Background: Based on early studies in the lamb, and in spite of more recent studies in humans, it has been the received opinion that neonates and infants can not change their stroke volume significantly, but are mainly dependent on changes in heart rate, to change cardiac output. To further evaluate the relationship between cardiac output and stroke volume during mechanical ventilation of neonates and infants, we have studied the effects on cardiac output and stroke volume by two different ways of changing mean airway pressure.

Methods: In one group, mean airway pressure was decreased by using a patient triggered mode: pressure support ventilation; in the other, mean airway pressure was increased by increasing positive end-expiratory pressure (PEEP).