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Shunt extra-pulmonaire prédominant « Recrutement vasculaire » Réduire les Résistances Vasculaires pulmonaires AP R A VD PV OG VG
1. Attention aux facteurs aggravants (déclenchant) Surdistention pulmonaire RVP V Houfflin. Am J Physiol, 2005 PVR(mmHg/mL/min) 1.2 1.0 0.8 0.6 0.4 Stress -20 0 20 40 60 80 100 120 140 Time (min) RVP suf+formol (n=6) formol (n=8) Stress Dopamine Jaillard S, Am J Physiol. 2001 Bouissou, J Pediatr 2008
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Causes : • Retard de résorption
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Causes : • Autres causes : Infec
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Ralentissement du développement pu
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Détresse respiratoire modérée du
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Détresse respiratoire sévère du
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Prise en charge 1. Traitement prév
Page 13 and 14:
Prise en charge 1. Traitement prév
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Alvéoli PPC nasale Thorax Abdomen
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Headbox N=149 2920 g 36 S N=300 CPA
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N=1316 GA 24 - 27 Weeks NCPAP N=653
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N=208 Mean GA = 27 Weeks NCPAP N=10
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N=616 Mean GA = 27 Weeks NCPAP N=31
Page 25 and 26:
« Alveolar hypoventilation syndrom
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Dynamic elevation of FRC through :
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Effect of NCPAP on the end-expirato
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FRC 0 cmH 2O VT Closing volume 4 cm
Page 33 and 34: 1 0,8 0,6 0,4 0,2 0 Effects of Vari
Page 35 and 36: What are the physiological effects
Page 37 and 38: Rib cage Thoraco-abdominal asynchro
Page 39 and 40: Multiple NCPAP devices
Page 41 and 42: Multiple NCPAP prongs 41
Page 43 and 44: Childs, Neonatal Intensive Care, 20
Page 45 and 46: Infant-Flow @ LP Inspiration Expira
Page 47 and 48: Variable-Flow CPAP High gas flow Hi
Page 49 and 50: In Premature infants < 1000 g, Bina
Page 51 and 52: 14 12 10 8 6 4 2 0 Change in FRC (m
Page 53 and 54: In preterm < 2000 g, Nasal short pr
Page 55 and 56: High flow nasal cannula Lampland A,
Page 57 and 58: Résultats FR / min Babyflow Infant
Page 59 and 60: Constant-Flow NCPAP Variable-Flow N
Page 61 and 62: Effects of CPAP devices on the thor
Page 63 and 64: In preterm infants, Mean GA 31.5 we
Page 65 and 66: 20 preterm infants GA : 26 weeks BW
Page 67 and 68: Pressure controlled NCPAP (SLE1000)
Page 69 and 70: Effet de l’installation sur l’e
Page 71 and 72: 2. Traitement curatif Management de
Page 73 and 74: Valeur cible de SpO 2 Pré-ductal :
Page 75 and 76: PA de 0.25 à 0.35 m.s LPA DA Ao Do
Page 77 and 78: Alvéoli Alvéoli VmoyAPG > 0.2 - 0
Page 79 and 80: Recrutement alvéolaire 1. Pression
Page 81 and 82: Pressure = EaDi x NAVA gain Measure
Page 83: Recrutement alvéolaire 2. Surfacta
Page 87 and 88: 3. Corriger une acidose respiratoir
Page 89 and 90: 4. NO inhalé (10 à 40 ppm) Alveol
Page 91 and 92: PvO2 VO 2 Débit d’O 2 délivré
Page 93 and 94: NO i ? NO i / PGI 2 HTAP OD VD CA O
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