In-house deliveries require transport from labor and delivery (L&D) to the NICU.
This is accomplished in a warm transport Isolette. These isolettes have a ventilator
attached as part of the unit. Pulse oximetry and cardiorespiratory (CR) monitoring are
also part of many units.
MINIMIZING LUNG INJURY
- ARDS net Trial: NEJM 2006
TV of 6 mL/kg of 1BW and Pplat < 30 cm/LH20 decreased all cause 28 day
mortality. - FACT trial: NEJM
CVOP= 4 or PAOP= 8, Increased ventilator five days by 0.6 days, decrease
ICU days. There was a trend to reduced mortality (underpowered). There was an
increase in the use of vasopressors. - JAMA 2008
2 groups were randomized to PEEP 5-9 and higher PEEP while keeping Pplat
(28-30). There were no mortality benefits with higher PEEP. - Late steroid rescue study for ARDs NEJM 2006: 354; 1671. No significant difference
between steroid vs no steroids regarding mortality.