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Carnitine and neonatal lipid metabolism

1984; Elsevier BV; Volume: 105; Issue: 5 Linguagem: Inglês

10.1016/s0022-3476(84)80325-x

1097-6833

Eberhard Schmidt‐Sommerfeld, Duna Penn,

Clinical Nutrition and Gastroenterology

The lateral decubitus position has been applied successfully by us at two other institutions.In 4 years 18 premature patients were treated via this maneuver at the University of Washington Hospital in Seattle.After treatment with decubitus positioning for periods ranging from 7 to 25 days, there was complete resolution of PIE in 16 and one responded initially but had a late recurrence.Lobectomy was required in one infant with treatment failure.One patient initially responded to 3 days of positioning for right-sided PIE, but 1 week later developed left-sided PIE that was successfully treated with 3 days of positioning.Several other patients have been successfully treated via the lateral decubitus position at Mt. Zion Hospital and Medical Center in San Francisco.We also observed one patient there in whom PIE was initially treated with extubation.Thereafter, without further exposure to positive airway pressure, the PIE progressed, resulting in mediastinal shift, contralateral atelectasis, and respiratory failure, demonstrating the susceptibility of certain predisposed neonatal lungs to this pathologic process.We continue to believe that the lateral decubitus position appears to be a relatively benign, noninvasive therapeutic maneuver that should be attempted before more invasive methods are used to treat serious focal pulmonary interstitial emphysema.However, caution should be exercised and the patient closely monitored when it is used.