動脈血ガス分析成績よりみた新生児呼吸障害の臨床的研究

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  • Clinical Studies on Respiratory Disorders of Newborn Infants Based on Results of Arterial Blood Gas Analysis
  • ドウミャクケツ ガス ブンセキ セイセキ ヨリ ミタ シンセイジ コキュウ シ

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Four hundred and twenty four premature infants had been admitted in the premature infant nursery of Pediatric Department, Kansai Medical University for five years from 1968 to 1972. They were studied statistically, especially on mortality and morbidity of respiratory disorders at first and then relationship between arterial blood gas analysis and clinical symptoms was studied mainly on these infants with respiratory disorders and the following results were obtained.<BR>1) Seventy eight cases of 424 admitted infants died of various conditions and the mortality rate in this nursery (all infants were transported out of the hospital) was 18.3 %. Fourty two cases died of idiopathic respiratory distress syndrome, which showed the highest mortality of 9.9%.<BR>2) Arterial blood gas analyses were done on two samples, arterialized blood obtained by heel puncture and radial artery blood. It was confirmed that the arterialized blood from heel puncture could not be used for monitoring PaO2.<BR>3) Comparing Silverman's retraction score and blood gas analysing results between infants transported in incubator and infants without incubator, the former showed the better data in blood gas analysis. It was emphasized that infants with respiratory distress should be transported in incubator.<BR>4) Silverman's retraction score in IRDS correlates well to results of blood gas analysis, and may be an effective index to show the course of IRDS, if blood gas analysis is not available.<BR>5) Evaluation of high risk infants by means of results of blood gas analysis immediately after admission is very important for an assessment of prognosis and decision of therapeutic regimens. The blood gas analyser, therefore, should be used in the nursery, to check the blood at whenever time necessary.<BR>6) It was reconfirmed that the blood gas analysis is indispensable as a fundamental test to assess the effects of treatments, including oxygen therapy and alkali therapy for high risk infants, especially for IRDS.

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