• I Martos Sánchez, J L Vázquez Martínez, E Otheo de Tejada, P Ros, and Sociedad Española de Cuidados Intensivos Pediatricos.
• Unidad de Cuidados Intensivos Pediátricos, Hospital Ramón y Cajal, Madrid, España.
• An Pediatr (Barc). 2003 Nov 1;59(5):483-90.

AbstractThe management of hypoxic respiratory failure is based on oxygen delivery and ventilatory support with lung-protective ventilation strategies. Better understanding of acute lung injury have led to new therapeutic approaches that can modify the outcome of these patients. These adjunctive oxygenation strategies include inhaled nitric oxide and surfactant delivery, and the use of prone positioning. Nitric oxide is a selective pulmonary vasodilator that when inhaled, improves oxygenation in clinical situations such as persistent pulmonary hypertension of the newborn, pulmonary hypertension associated with congenital heart disease, and acute respiratory distress syndrome (ARDS). When applied early in ARDS, prone positioning improves distribution of ventilation and reduces the intrapulmonary shunt. The surfactant has dramatically decreased mortality caused by hyaline membrane disease in premature newborns, although the results have been less successful in ARDS. Greater experience is required to determine whether the combination of these treatments will improve the prognosis of these patients.

19 keywords...

hide…