Mechanical Ventilation Strategies.The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN

Recommendations

1.After stabilization, MV should be used in babies with RDS when other methods of respiratory support have failed (A1). Duration of MV should be minimized (B2).

2.Targeted tidal volume ventilation should be employed as this shortens the duration of ventilation and reduces BPD and intraventricular haemorrhage (A1).

3.HFOV may be useful as a rescue therapy (B).

4.Avoid hypocarbia (A1) as well as severe hypercarbia (C2) as these are associated with an increased risk of brain injury. When weaning from MV, it is reasonable to tolerate a modest degree of hypercarbia, provided the pH remains above 7.22 (B2).

5.Caffeine should be used to facilitate weaning from MV (A1). Early caffeine should be considered for all babies at high risk of needing MV, such as those <1,250 g birth weight, who are managed on non-invasive respiratory support (C1).

6.A short tapering course of low-dose dexamethasone should be considered to facilitate extubation in babies who remain on MV after 1–2 weeks (A2).

7.Inhaled steroids can be used to reduce BPD.

  • Quality of evidence

   – High quality A

   – Moderate quality B

   – Low quality C

   – Very low quality D

MODIFIED FROM:

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2016 Update

Sponsored by: abbvie EGYPT

Sharing professors:

  • Prof Abdel Rahman El Mashad (Tanta univ)
  • Prof Afaf Korraa (Azhar univ)
  • Prof El Sayed Khalaf (Port fouad hosp, ministry of health)
  • Prof Iman Eskander (Cairo univ)
  • Prof Hesham Abdel Hady (Mansoura univ)
  • Prof Hesham Ghazal (Alexandria univ)
  • Prof Magda Badawy (Cairo univ)
  • Prof Madiha Abdalla (Minia univ)
  • Prof Magdy Kamel (Minia univ)
  • Prof M Abdel Aaal El Bagy (Sohag univ)
  • Prof Morad El Alfy (Al Galaa military center)
  • Prof Nahed Fahmy (Cairo univ)
  • Prof Nayera Ismaeil (Ain Shams univ)
  • Prof Raguia Atwa (Ain Shams univ)
  • Prof Safaa Shafeek (Ain Shams univ)
  • Prof Sozan Gad (Suez canal univ)
  • Prof Osama Hussein (Port said neonatology society)
  • Prof Osama Kasem (Al Galaa military center)
  • Prof Yehia Mahmoud Basha (Damanhour teaching hosp)
  • Prof Zahraa Ezz El Deen (Cairo univ)