[Computer-assisted respirator treatment of neonates]

A retrospective investigation was undertaken to assess the value of a knowledge-based computer programme for improved respirator treatment of neonates in ventilators. On the basis of the arterial gas values from 30 premature infants with birthweights of under 1,500 g and suffering from the respiratory distress syndrome, the alterations in ventilator settings which were made were compared with the suggestions made by the programme. The programme was in agreement with the written instructions in the department. Complete agreement was found between the adjustments actually made and those suggested by the programme in 37.5% and complete or partial agreement in 68% of the infants. Agreement was poorest among the infants who died from respiratory insufficiency or who developed pneumothorax. A frequent cause of defective agreement was that ventilator settings were not adjusted according to the gas values recorded. The sequel of this was most frequently absence of improvement or deterioration in the subsequent gas values. This occurred most frequently during night hours. This investigation reveals that respirator treatment of neonatal infants is difficult and that easily accessible qualified advice is required.