Objective To investigate the effects of exogenous pulmonary surfactant （PS） on ventilation weaning and respiratory mechanics in infants with acute lung injury（ALI） after cardiopulmonary bypass （CPB）.Methods Twelve infants underwent cardiopulmonary bypass cardiac surgery committed with ALI and difficulty in weaning from ventilation were included in this study.Exogenous PS was used in the treatment via intra-tracheal administration.The changes of blood gas，respiratory mechanics and the conditions of ventilation weaning were observed.Results After intra-tracheal PS administration，spontaneous breath remained steady；spontaneous respiratory rate significantly decreased from，tidal volume of spontaneous breath increased significantly.Three concave sign disappeared and koilosternia was alleviated.PaCO2 value decreased significantly and peak inspiratory pressure（PIP） decreased from （36.18±10.25）cm H2O to （25.11±5.14）cm H2O （Plt;0.01）.Static lung compliance （Cstat） increased from （1.49±0.65）mL·cm H2O-1·kg-1 before treatment to （1.95±0.50） mL·cm H2O-1·kg-1 6 h after treatment （Plt;0.01）；and airway resistance （Rstat）decreased from （128.17±26.34） cm H2O·L-1·s-1 before treatment to （78.56±18.22） cm H2O·L-1·s-1 6 h after treatment （Plt;0.01）.All 12 infants weaned from ventilator successfully.Conclusion Combined with PS intra-tracheal treatment，lung protective ventilation strategy can significantly improve parameters of respiratory mechanics，increase dynamic lung compliance，decrease airway resistance，which can decrease the breathing effort of the infants and make it easy to wean from ventilator.
Objective To systematically review the efficacy of salbutamol for infants with bronchiolitis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CBM, VIP, WanFang Data and CNKI were searched from inception to March 2016 to collect randomized controlled trials (RCTs) about salbutamol for infants with bronchiolitis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 20 RCTs, involving 1 735 patients were included. The results of meta-analysis showed that, compared with the control group, the salbutamol group had shorter cough relief time (MD= –1.44 d, 95%CI –1.93 to –0.95, P < 0.000 01), dyspnear relief time (MD= –0.87 d, 95%CI –1.17 to –0.56, P < 0.000 01), asthmatic remission time (MD= –1.38 d, 95%CI –1.93 to –0.83, P < 0.000 01), pulmonary rales disappear time (MD= –1.58 d, 95%CI –2.00 to –1.17, P < 0.000 01) and average hospitalization time (MD= –1.40 d, 95%CI –2.12 to –0.68, P=0.000 1), but could not improve clinical severity score (MD= –0.17, 95%CI –0.35 to 0.00, P=0.05). Conclusion Current evidence indicates that salbutamol can significantly improve the bronchiolitis with cough, dyspnea and wheezes symptoms and lung’s signs, shorten the length of hospital stay, but can not improve the clinical severity score of infants with bronchiolitis. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the treatment method of congenital heart disease (CHD) with pulmonary artery hypertension (PAH) in infants with Down syndrome (DS). Methods The clinical data of 60 CHD patients with PAH from March 2015 to August 2016 in our hospital were retrospectively analyzed. There were 30 infants with DS classified as a DS group (trial group, 17 males and 13 females with a mean age of 1.15±0.25 years) and the other 30 patients without DS were classified as a control group (20 males and 10 females with a mean age of 1.24±0.30 years). All the patients underwent surgical treatment and fasudil combined with sildenafil were used to prevent pulmonary hypertension crisis postoperatively. Results There was no significant difference in cardiopulmonary bypass time, aortic cross-clamping time, modified ultrafiltration time and the incidence of postoperative respiratory complications between the two groups. The pulmonary systolic blood pressure significantly decreased at 24 h after operation in the two groups (both P<0.05). The arterial oxygen pressure and oxygenation index of the trial group were lower than those of the control group at 6 h after operation (both P<0.05). The mechanical ventilation time and intensive care time of the trial group were significantly longer than those of the control group (P=0.007 and P=0.000, respectively). There were no reoperations or early death. Conclusion The effects of surgical repair of CHD with PAH in infants with DS are satisfactory by grasping the indication, protecting lung function and controlling PAH in the early postoperative period, although there is a high incidence of pulmonary complications.
Myocardial and cerebral protection are always the major concerns in neonatal aortic arch surgery. From the application of deep hypothermic circulatory arrest technology to continuous cardio-cerebral perfusion strategy adopted in many cardiac centers recently, each perfusion method has its own pros and cons, so there is no consensus on which one is the most suitable. This review aims to summarize the development and research progress of various perfusion methods, so that to provide a foundation for further development.
Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by melaminetainted milk powder in Gansu province. Methods Questionnaires were distributed to 7 856 infants who were screened for urolithiasis in the Second Hospital of Lanzhou University by ultrasound examination from September 25, 2008 to November 15, 2008. Data were collected by Excel and analyzed by SPSS 13.0 software. Results A total of 4 090 (52.06%) male infants and 3 766 (47.94%) female infants underwent ultrasound examination in the Second Hospital of Lanzhou University. The mean age of the infants with urolithias was 18.30±9.68 months. Of those, 704, including 434 males (61.65%) and 270 females (38.35%), were diagnosed with urolithiasis, with an incidence of 8.96%, and 99.14% of calculus was located in kidney. And, 58 aged 0-6 months with an incidence of 3.16%, 218 aged 6-12 months with an incidence of 11.01%, 275 aged 12-24 months with an incidence of 12.55%, and 153 aged 24-36 months with an incidence of 8.27%. The relationship between the incidence of urolithiasis and gender as well as age was assessed by using the Pearson Chi-square test. The results showed significant differences in the incidence of urolithiasis among infants of different genders and different ages (Plt;0.05). The result of multiplelogistic regression analysis indicated that gender was related to the incidence of urolithiasis (Plt;0.05). Conclusion The incidence of urolithiasis in the infants aged 0-3 years old in Gansu province is relatively high. The incidence of urolithiasis focuses on the infants aged 6-24 months and has anatomical specificity.