Despite improvement of mechanical ventilation devices for infants, Lung injury still causes morbidity and mortality in any cases. To determine the effect of high frequency oscillatory ventilation (HFOV) in infants with severe Respiratory Failure, ten neonates were evaluated prospectively. Mean gestational age of these patients was 35 weeks and alveolar – arterial oxygen gradient (A – aDo2) and the ration of arterial to alveolar oxygen pressure (a / A) immediately before HFO were 610 torr and 0.072 respectively. These neonates were received inspired oxygen concentration of >95 % with a mean airway pressure of 12 cm H2O by conventional mechanical ventilation.The A – aDo2 and a / A after 6 and 24 hrs on HFO was not significant in those infants who survived compared with those who died.Comparison of 3 alive neonates with 7 death, demonstrate that pulmonary hypoplasia, HMD accompanied with asphyxia, congestive heart Failure with pneumonia are associated with poor outcome.The mean a / A ratio during 24 hrs of HFO in the alived HMD group was 0.75 compared with 0.25 in those who died. It is possible that we can use this as a prognostic factor in survival. In this study, the Positive effect of HFOV was demonstrated in those with no predisposing factors such as pulmonary hypoplasia, congestive heart Failure, pneumonia and asphyxia.

Background: Non-invasive mechanical ventilation is one of the most used organ support measures in critical care medicine. Hemet interface has been implemented in everyday practice at ICUs later than classic means of delivery for NIV including face mask. We used helmet interface for first time at ICU and recorded CPAP setting and outcome. Methods: Helmet was used for 9 patients and any complication or side effects were recorded. Also nurses first experience of using the helmet has recorded in a survey. Results: No skin lesion, vomiting, and air leaking were recorded. Also none of the patients complained about claustrophobia, dyspnea, pain, or feeling hot while the helmet was in use. In addition, nursing was easier while using a helmet than it was with face mask. Conclusion: The overall first time use of helmet interface in our department gave us a positive feedback, but more data need to be collected for more effective way of applying NIV and specifically helmet interface.

Background: Acute Respiratory Failure (ARF) is an important presentation in emergency department (ED). Intubation and mechanical ventilation (MV) are sometimes the ultimate decisions in such emergent situations. Many of these patients are unfortunately managed in an ED. This may endanger their outcome. This study was aimed to compare the outcome of critically ill patients with ARF under MV admitted to ED with patients admitted to ICU. Methods: All critically ill patients with ARF who were intubated and placed under MV were enrolled in this study. Cases were either admitted to ED or ICU. Demographic data, initial diagnosis, final diagnosis, length of hospital stay, one-month mortality rate, number of times patient was intubated and number of times patient was resuscitated were all recorded and compared between the 2 groups. Results: Out of all 172 patients admitted to ED and ICU, 74 (43%) were females and 98 (57%) were males. Patients had a mean±, SD age of 64. 2±, 18. 1 years. ICU patients (85 patients (49. 4%)) had a significantly longer hospital stay (p=0. 048). ICU patients had significantly more resuscitation process (p=0. 006). Mortality rate in ICU was significantly higher than ED. In the meanwhile, more patients in ED finally survived (p=0. 004). Conclusion: In the present study, ICU patients were admitted longer to the ward than ED patients. Overall, ED mortality rate was lower than ICU. More patients finally survived in ED in comparison to ICU.

Background and objectives: Guillain Barre Syndrome is the most common peripheral neuropathy causing Respiratory Failure, and about 10-30% of these patients require mechanical ventilation sometimes during their illness.Materials and methods: Ninety one children under 15years old with GBS were studied over a period of 3 years. Thirteen (14.4%) of these patients required assisted ventilation. A comparison was made between the clinical, electrodiagnostic, and laboratory data from patients who required mechanical ventilation and those who did not. Results: Progression to Respiratory Failure necessitating mechanical ventilation was highly likely to occur in those with younger age (p=0.001), cranial nerve involvement (p=0.03), and loss of deep tendon reflexes in upper limbs (p=0.04), lack of motor unit action potential (p=0.009) or presentation of fibrillation potentials (p<0.0001) on electromyography and markedly attenuated (>80%) CMAP amplitude on nerve conduction study (p<0.0001) were significantly more common in the ventilated group.Conclusion: While inherently unpredictable, the clinical course of patients with severe GBS may be predictable to some extent, on the basis of clinical information and electrodiagnostic findings.

Background and Objective: Respiratory Failure is one of the most important Respiratory problems in premature infants. Several studies have shown the efficacy of corticosteroids in gestational age less than 34 weeks. This study was done to determine the effect of prenatal betamethasone injection during 34 to 36 weeks of pregnancy on the prevention of newborn Respiratory Failure.Methods: This clinical trial study was conducted on 140 women with risk of preterm labor at 34 to 36 weeks of gestational age. Women in interventional group were received betamethasone 12 mg IM (2 doses, 12 hours apart).Women in control group were received the same volume of normal saline. Sex and birth weight, Respiratory distress syndrome, requiring hospitalization in neonatal intensive care units and require Respiratory support were recorded for each newborn.Results: No significant difference was seen in sex and weight of newborns between two groups. The precent of newborns with Respiratory distress syndrome in the intervention and control groups was 12.5% and 22%, respectively. This difference was not significant. No significant difference was seen in the need to Respiratory support, hospitalized in the NICU between intervention and control groups.Conclusion: Adminestration of betamethasone in 36-34 weeks of pregnancy has no effect on the prevention of Respiratory Failure in preterm infants.

Objective: The objective of the study was to evaluate the effects of exogenous surfactant on Respiratory indices in term infants with Respiratory Failure.Methods: Consecutive 18 mechanically ventilated term infants, who received a single dose of exogenous surfactant were retrospectively included into the study. The Respiratory outcome of surfactant rescue therapy was evaluated by comparing Respiratory indices before and six hours after surfactant administration.Findings: Median oxygenation index (OI), mean alveolar pressure (MAP) and fraction of inspired oxygen (FiO2) values were significantly decreased (P<0.001); median arterial oxygen partial pressure (PaO2), arterial oxygen saturation (SaO2) and PaO2/FiO2 values were significantly increased six hours after surfactant treatment (P<0.001).Conclusion: Rescue therapy with surfactant was found to be effective in the improvement of early Respiratory indices in term infants with Respiratory Failure.