Infants May Not Require Ventilation During Transport

Infants with suspected duct dependent disease do not always need mechanical ventilation during transport

THURSDAY, March 8 (HealthDay News) -- Newborns born with suspected duct dependent congenital heart disease may not require routine mechanical ventilation when they are being transported, particularly if the infusion rate of prostaglandin E1 (PGE1) is lower than 15 ng/kg/min, according to study findings published in the March issue of the Archives of Disease in Childhood -- Fetal and Neonatal Edition.

Peter Barr, Ph.D., of the Children's Hospital at Westmead in New South Wales, Australia, and colleagues conducted a retrospective study of 300 infants with suspected congenital heart disease who were transported between 1995 and 2005.

Ninety-four infants did not require mechanical ventilation prior to treatment with PGE1, 125 were ventilated due to intention to use PGE1, and 81 were ventilated due to severe hypoxemia, acidosis or cardiorespiratory failure before treatment. Of the remaining infants, 17 percent required ventilation prior to transport as they developed apnea within one hour of PGE1 treatment and 2.6 percent (two infants) required ventilation during transport. Both of those infants were receiving PGE1 at an infusion rate of 15 ng/kg/min or greater.

In New South Wales, the use of low-dose PGE1 in newborn infants with suspected duct dependent congenital heart disease has become increasingly common, and the practice has been not to ventilate them routinely for transport, the authors write. This "practice has been demonstrably safe, since worrisome apnea has been very uncommon in transit in non-ventilated infants," they conclude.

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