Abstract
High frequency jet ventilation (HFJV) represents a radically different management approach to severe neonatal respiratory disease. In order to determine if HFJV could be augmented by the use of intermittent mandatory ventilation (IMV), two groups of infants were prospectively evaluated. Both groups consisted of 3 infants, two with severe RDS, one with pulmonary hypertension. Mean BW was similar (2.0 ± .6 SEM kg vs. 2.1 ± .7 SEM kg) as were GA (32.7 ± 3.4 wks vs. 24 ± 3.1 SEM wks). One group (HFJV-IMV) received HFJV (Bunnell Life Systems Inc.) (rate 400-500 bpm) and IMV (5 bpm). The other group received HFJV alone (rate 400-600 bpm). The HFJV-IMV group was treated for a mean of 112 ± 40.6 SEM hrs., the HFJV group was treated for a mean of 24.3 ± 13.6 SEM hrs. The HFJV-IMV group demonstrated a 13.3 ± 2.3 SEM cmH2O decrease in peak inspiratory pressure (PIP) and a 5.0 ± 1.1 SEM cmH2O decrease in mean airway pressure (MAP). PaO2 increased a mean of 66.0 ± 11.5 SEM torr, while PaCO2 decreased 13.6 ± 7.1 SEM torr. In the HFJV group there was a 9.6 ± 4.9 cmH2O decrease in PIP and a 3.3 ± 1.2 cmH2O decrease in MAP. PaO2 increased 31.3 ± 17.6 SEM torr, while CO2 showed a 4.3 ± 11.6 SEM torr decrease. Infants in both groups took 2.2 ± 0.4 SEM hours to stabilize on HFJV. One infant in each group survived and is entirely well at present. These preliminary data suggest that HFJV may be an effective therapy in severe neonatal respiratory disease. Augmentation of HFJV by IMV may be a valuable approach in some infants.
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Spitzer, A., Bunnell, B. & Fox, W. HIGH FREQUENCY JET VENTILATION (HFJV) WITH INTERMITTENT MANDATORY VENTILATION (IMV): A ALTERNATIVE APPROACH TO SEVERE NEONATAL RESPIRATORY DISEASE. Pediatr Res 18 (Suppl 4), 348 (1984). https://doi.org/10.1203/00006450-198404001-01533
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DOI: https://doi.org/10.1203/00006450-198404001-01533