CONTINUOUS DISTENDING AIRWAY PRESSURE IN THE MANAGEMENT OF CARDIORESPIRATORY FAILURE DUE TO PDA

Abstract

Patent ductus arteriosus (PDA) is a frequent complication in the recovery phase of respiratory distress syndrome. Ligation is recommended when heart failure cannot be controlled medically. Criteria and timing for surgery are controversial. Continuous negative or positive distending airway pressure (C.D.A.P.) was used in five infants < 1500 grams birthweight who had P.D.a. and had failed to respond promptly to routine medical treatment i.e. fluid restriction, digitalization and diuretics. Significant improvement was recorded in tiie following: 1) Number of apneic spells; 2)heart rate; 3)respiratory rate; 4)chest retractions; 5)pCO₂; 6)radiologic picture of pulmonary edema; 7)tolerance to oral and IV alimentation; 8)daily fluctuation of weight; 9)electrolyte imbalance due to occasional use of diuretics. A negative pressure respirator was used in most cases for obvious technical advantages. Mean pressure was 4cm H₂O. We conclude that C.D.A.P. is iielpful in overcoming cardiorespiratory failure due to P.D.A.

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