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High-Frequency Oscillation and Paralysis Stabilize Surfactant Protein-B–Deficient Infants

Journal of Perinatology volume 21, pages 421–425 (2001)Cite this article

Abstract

OBJECTIVE: To determine if high-frequency oscillatory ventilation and neuromuscular blockade improve oxygenation and chest radiographic appearance more effectively than high-frequency oscillation alone for surfactant protein-B (SP-B)–deficient infants.

STUDY DESIGN: We reviewed medical records and chest radiographs of five SP-B–deficient infants awaiting lung transplantation. Changes in FiO2 and radiographic scores were analyzed with respect to neuromuscular blockade status.

RESULTS: FiO2 consistently increased 0.20 (SD 0.11) during high-frequency ventilation without neuromuscular blockade (p=0.02) and decreased 0.14 (SD 0.11) during high-frequency ventilation with neuromuscular blockade (p=0.05). Chest radiographic appearance, quantified by an expansion/aeration index, consistently deteriorated without neuromuscular blockade (p=0.01) and consistently improved with neuromuscular blockade (p=0.03). Changes in FiO2 correlated with changes in radiograph scores (r=0.7, p<0.001).

CONCLUSIONS: High-frequency ventilation with neuromuscular blockade optimizes oxygenation for SP-B–deficient infants. This ventilatory strategy should be considered while awaiting the diagnosis of SP-B deficiency or lung transplantation.

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Acknowledgements

We thank Corrine Hamvas for data acquisition, F.S. Cole, MD, for review of the manuscript and Dawn Rouse for secretarial assistance.

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Authors and Affiliations

  1. Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, MO, USA

    Erin L King BA & Aaron Hamvas MD

  2. Mallinckrodt Institute of Radiology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, MO, USA

    Gary D Shackelford MD

Authors
  1. Erin L King BA
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  2. Gary D Shackelford MD
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  3. Aaron Hamvas MD
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Additional information

This study was supported in part by National Institutes of Health HL/HD54187 (A.H.). An abstract based on these data was presented at the American Thoracic Society International Conference, 16–21 May 1997, San Francisco, CA (Am J Respir Crit Care Med 1997;155:A236).

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King, E., Shackelford, G. & Hamvas, A. High-Frequency Oscillation and Paralysis Stabilize Surfactant Protein-B–Deficient Infants. J Perinatol 21, 421–425 (2001). https://doi.org/10.1038/sj.jp.7210555

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