Preoperative management of congestive heart failure in neonates: the closed hood

In this study we report the results of the use of a closed hood with no external administration of CO 2 to increase pulmonary vascular resistance by lowering the inspired fraction of oxygen (FiO 2) and raising the inspired fraction of carbon dioxide (FiCO 2) in patients with congenital heart disease and increased pulmonary blood flow. Between December 1995 and May 1996, 9 neonates (F:5, M:4) were admitted. Each study patient was assigned to clinical classes using a 1 to 4 classification. Ages ranged between 2 and 30 days (mean 18), weight between 2.25 and 3.65 kg (mean 2.89). A plastic hood, closed on the top with a plastic membrane and with the gas entrance open to room air was placed over the head of the patients. Patients increase pCO 2 by rebreathing their own expired CO 2. After 24 h of the onset of the treatment the media of points of congestive heart failure 1 to 4 classification decrease from a mean of 4 to a mean of 2.28±0.44 ( p=0.001). A statistically significant improvement in symptoms and lowering of pO 2 and pH while raising pCO 2 has been demonstrated in this study.