PEDIATRICS Vol. 51 No. 4 April 1973, pp. 748-750
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Objective Early Criteria for Ventilatory Assistance in Hyaline Membrane Disease

Meade P. O'Boyle M.D.1, Anne B. Fletcher M.D.1, and Gordon B. Avery M.D., Ph.D.1

1 Children's Hospital of the District of Columbia, Department of Child Health and Development, George Washington University School of Medicine, Washington, D.C. 20009

Ventilatory assistance utilizing a respirator and/or continuous positive airway pressure (CPAP) is commonly employed in the treatment of severe hyaline membrane disease (HMD).1 Artificial ventilation is indicated when the following classical blood gas criteria are met: (1) Pao2 [unknown] 40 mm Hg in an inspired oxygen concentration (Fio2) of 100%, (2) Paco2 [unknown] 70 mm Hg, (3) pH [unknown] 7.20, or (4) prolonged apnea.2,3 Typically, ventilation is postponed until the infant is moribund.4 Stern5 and Chernick and Vidyasagar6 suggest that earlier intervention might increase the survival of babies with HMD.

The classical blood gas criteria have been used at Children's Hospital of D.C. to indicate whether intervention is required.