Efficacy of lung volume optimization maneuver monitored by optoelectronic pletismography in the management of congenital diaphragmatic hernia

G Lista; I Bresesti; F Cavigioli; F Castoldi; E Lupo; A LoMauro; A Aliverti

doi:10.1016/j.rmcr.2017.07.013

Efficacy of lung volume optimization maneuver monitored by optoelectronic pletismography in the management of congenital diaphragmatic hernia

Respir Med Case Rep. 2017 Jul 29:22:133-136. doi: 10.1016/j.rmcr.2017.07.013. eCollection 2017.

Authors

G Lista¹, I Bresesti¹, F Cavigioli¹, F Castoldi¹, E Lupo¹, A LoMauro², A Aliverti²

Affiliations

¹ Division of Neonatology, "V.Buzzi Children's Hospital" - ASST FBF-Sacco, Milan, Italy.
² Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.

Abstract

Newborns affected by congenital diaphragmatic hernia (CDH) need cardio-respiratory stabilization before undergoing surgical repair. Open lung strategy is a well-established approach to optimize lung volume in preterm infants with Respiratory Distress Syndrome (RDS), using both High Frequency Oscillatory Ventilation (HFOV) and Conventional Mechanical Ventilation (CMV). We report a case of left CDH with severe lung hypoplasia, managed applying open lung strategy in HFOV (pre-surgery period) and in Assist-Control with Volume Guarantee (post-surgery period), guided by SpO₂ changes, TcPO₂ and TcPCO₂ monitoring. Opto-electronic plethysmography was used to measure end-expiratory chest wall volume changes (ΔEEcw) related to lung volume variations occurring during pressure changes. OEP confirmed the efficacy of using SpO₂ and transcutaneous gas monitoring during this recruitment maneuver.

Keywords: CDH; Lung volume; Newborn; Opto-electronic plethysmography; Ventilation strategy.

Publication types

Case Reports