A neonatal patient has unsuccessfully undergone the subsequent ...

[penza]

A neonatal patient has unsuccessfully undergone the subsequent therapeutic interventions: (1) surfactant replacement therapy, (2) inhaled nitric oxide, and (3) lung protective ventilation often with permissive hypercapnia. Which of the following forms of therapy should the therapist recommend at this time?
 
  A. extracorporeal life support
  B. high-frequency ventilation
  C. venovenous bypass
  D. intravascular oxygenation

Question 2

The therapist is caring for a neonate who has a persistent significant air leak, an oxygenation index of 50, and a P(A-a)Do2 greater than 550 for the last 5 hours. What therapeutic intervention should the therapist recommend at this time?
 
  A. extracorporeal life support
  B. intravascular oxygenation
  C. surfactant replacement
  D. high-frequency ventilation

[mrphibs]

Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: For all age groups, ECLS usually is considered after failure of other available therapies such as surfactant replacement, high-frequency ventilation, inhaled nitric oxide, and lung protective ventilation strategies often with permissive hypercapnia.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

Answer to Question 2

ANS: A
A. Correct response: Generally, a neonate who has a persistent significant air leak, an oxygenation index (OI) greater than 40, and an alveolar-arterial O2 difference (i.e., P(A-a)Do2) greater than 500 for 4 or more hours meets ECLS criteria.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.