The Effect Of Frequency Mechanical Ventilation On Brain Injury In Very Low And Extremely Low Birth Weight Infant

ObjectiveTo explore the influence of mechanical ventilation on brain injury in very low and extremely low birth weight(VLBW and ELBW) infant and risk factors related brain damage in VLBW and ELBW infants with mechanical ventilation.MethodsThe study was prospectively performed on 82 VLBW and ELBW infants with mechanical ventilation and 82 VLBW and ELBW infants without mechanical ventilation at the same period from March 2007 to December 2009 at the neonatal intensive care unit of the Shengjing Hospital of China Medical University. Detailed clinical and imaging data of all subjects were analyzed,the rate of brain injury between the two groups was compared. The 82 VLBW and ELBW infants with mechanical ventilation were divided into three groups:non-cerebral hemorrhage group (37),and white matter damage(WMD) group (22)and non-injury group (23). The highest and lowest values of PaCO2,PaO,the highest values of PIP, PEEP, respiratory rate and days of ventilation were compared in the three groups.ResultsThe rate of total brain injury,non-cerebral hemorrhage and WMD in VLBW and ELBW infants with mechanical ventilation was respectively 71.95%,45.12%(severe IVH 9.76%) and 26.82%; The rate of total brain injury,non-cerebral hemorrhage and WMD in control group was respectively 37.80%,25.61%(severe IVH 2.44%) and 12.20%; The rate of total brain injury,IVH and WMD in VLBW and ELBW infants with mechanical ventilation significantly higher and the degree was more serious than that of control group.In the mechanical ventilation group, there was no significant difference in the highest and lowest values of PaO2,the highest values of PIP, PEEP, respiratory rate and days of ventilation in non-cerebral hemorrhage group,WMD-group and non-injury group. The difference in the highest values of PaCO2 between non-cerebral hemorrhage group and non-injury group were considered statistically significant, and there was also significant difference in the lowest values of PaCO2 between WMD-group and non-injury group.ConclusionThe incidence of brain injury significantly higher than non-mechanical ventilation group in VLBW and ELBW infants; The form of brain damage is in mechanical ventilation infants is still mainly non-cerebral hemorrhage, followed by white matter damage. Hypercapnia. hypocapnia and hypotension generated in mechanical ventilation may induce or aggravate brain injury in VLBW and ELBW infants.