Persistent fetal circulation in neonates postoperatively: the value of manual ventilation

Three critically ill infants who had persistent fetal circulation postoperatively, refractile to tolazoline and 100% oxygen with mechanical ventilation including continuous positive airway pressure, responded favourably to prolonged manual hyperventilation. Two infants had undergone repair of a diaphragmatic hernia and the third had correction of a tracheoesophageal fistula. Normal respiratory function was documented in two survivors. The third died 14 days postoperatively. The use of this simple technique indicated that perseverance can be rewarded in the treatment of persistent fetal circulation unresponsive to the usual medical management.