Integrated Echocardiography and Chest Ultrasound Assessment of Lung Recruitment in Preterm Infants Using High Frequency Ventilation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Ventilator Lung
- Sponsor
- Alexandria University
- Enrollment
- 72
- Locations
- 2
- Primary Endpoint
- chest US
- Status
- Recruiting
- Last Updated
- 11 months ago
Overview
Brief Summary
The primary aim of this work is to evaluate the role of high frequency oscillatory ventilation (HFOV) in recruitment of lung in preterm newborns 32 to 37 weeks gestational age with moderate to severe respiratory distress. The secondary aim is to evaluate the role of chest ultrasound in monitoring of lung recruitment in comparison to routine chest x ray in those babies. Also cardiac hemodynamics will be assesed using functional echocardiography.
Investigators
Marwa Mohamed Farag
Primary Investigator and Lecturer in Pediatrics, Faculty of Medicine
Alexandria University
Eligibility Criteria
Inclusion Criteria
- •Infants will be enrolled if they are 32 to 37 weeks of gestational age, have respiratory distress (RD) in the first 24 h of life, intubated and have invasive respiratory support using HFOV. Signs of RD are tachypnea (respiratory rate \> 60/min), grunting, nasal flaring, chest retraction, and need of oxygen supplementation or other respiratory support.
Exclusion Criteria
- •Known major congenital anomalies including congenital heart diseases.
- •Fetal hydrops.
- •Babies with congenital heart diseases
Outcomes
Primary Outcomes
chest US
Time Frame: first 3 days after birth
A mobile device (PHILIPS ® HD11 XE) with a 10-MHz linear probe will be used for chest ultrasound the 12 lung zones will be assessed regarding 1. presence Of A lines, B-lines or C-profile 2. presence or absence of pleural sliding
estimated pulmonary artery pressure in mmHg
Time Frame: first 3 days of life
Pulmonary artery pressure (PAP) will be assessed by measuring tricuspid valve regurgitation peak velocity: this will be measured in apical 4 chamber view, with continous wave Doppler using modified Bernoulli equation. Systolic pulmonary artery pressure is equivalent to right ventricular systolic pressure in absence of outflow obstruction. Systolic Pulmonary Artery Pressure (SPAP) = Right Ventricular Systolic Pressure = 4x TR2 + Right Atrial Pressure (RAP), with RAP= 3-5 mmHg.
Superior Vena Cava flow in ml/kg/min
Time Frame: first 3 days of life
Superior Vena Cava (SVC) Blood Flow using functional echocardiography