Neonatal revolution - the introduction of PEEP.

Abstract

Fifty years ago, a baby born at 24-26 weeks was not considered viable. It was a tragedy for the mother having carried it for so long. I witnessed such an event as a student. The scourge of premature deliveries was the lack of surfactant in many tiny babies. In general, if a premature infant with hyaline membrane disease, as it was called respiratory distress syndrome (RDS), could not maintain a pO(2) above 60 mmHg in 100% oxygen, it was not expected to survive. In late 1969, two babies with suspected RDS came to ICU and were treated by the author with the buffer (tris hydroxyl amino methane, [THAM] which reduced both metabolic and respiratory acidosis and did not contain sodium) and an isoprenaline infusion (β(1) stimulant and pulmonary vasodilator). The X-ray appearances of RDS disappeared. Unfortunately, one died of portal vein thrombosis because the drugs were administered by umbilical catheter, which were commonly used at the time. The other one recovered but the physicians then said the diagnosis must have been wrong!

• Authors: T C K Brown
• Journal: Paediatric anaesthesia (Paediatr Anaesth) Vol. 21 Issue 10 Pg. 1071-2 (Oct 2011) ISSN: 1460-9592 [Electronic] France
• PMID: 21981092 (Publication Type: Historical Article, Journal Article)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Oxygen

Topics

• Airway Management (history, instrumentation)
• Anesthesiology (history)
• History, 20th Century
• Humans
• Hyaline Membrane Disease (therapy)
• Infant, Newborn
• Infant, Premature
• Oxygen (adverse effects)
• Pediatrics (history)
• Positive-Pressure Respiration (history, instrumentation)
• Respiratory Distress Syndrome, Newborn (therapy)
• Survival