A Study on the Risk Factors of Periventricular Leukomalacia in Combined Use with Gentle Ventilation and High-Frequency Ventilation

Kang, Suk Ho; Kim, Sung Eun; Hur, Man Hoi; Lee, Sang Geel

Abstract

PURPOSE: It is suggested that persistent hypocarbia caused by ventilator therapy could be a risk factor in PVL. The study is aimed to discover whether for preventing hypocarbia with combined use of gentle ventilation and high frequency ventilation, other factors would be causers of PVL.
METHODS
Among 45 infants who were born and survived through ventilator treatment in the Fatima neonatal intensive care unit for four years from April 1996 to June 1999, 15 infants with PVL were classified as a study group and 30 without PVL as control group. The analysis was performed retrospectively with medical records. Ventilator treatment was based on the combined use of ventilation by means of the flow interruptor type of Infant Star . The aggressive weaning was performed when the clinical state, chest X-ray and arterial blood gas analysis became stabilized.
RESULTS
Among 15 cases with PVL : 9 cases(60.0%) with fetal distress, 1 case(6.6%) with placenta previa, 1 case(6.6%) with placenta abruptio. In the relationship between PaCO2 variance on arterial blood gas analysis and PVL, the highest average of PaCO2 is 44.9 +/- 7.8 mmHg in the study group and 45.0 +/- 10.5 mmHg in the control group, which means there was not statistically significant difference. The PaCO2 concentration lower than 25 mmHg for three days appeared in one case in the study group.
CONCLUSIONS
In cases of preventing hypocarbia by combined use of ventilation, it is suggested that the birth history and weaning method is important as risk factor of PVL.