Abstract
Despite potential reduction of barotrauma, no controlled data are available on the incidence of adverse effects of long-term high frequency ventilation(HFV). To compare HFJV to pressure-limited time-cycled CV we screened 208 1-2 kg neonates and randomized those fulfilling all of 6 criteria by 24 hr: l)FiO2>.50; 2)peak insp. pressure(PIP) ≥20cmH2O; 3)positive end exp. pres-sure(PEEP) ≥4cmH2O; 4)frequency(f) ≥20/min;5)PaO2 <90mmHg; 6) PaCO2 ≥35mmHg. We randomized 18 neonates to HFJV (BW 1.5±.3kg, GA 31±2 wks) at a f=250/min and I:E=1:3, or CV (BW 1.5±.3kg, GA 30±2 wks) at 22±6 hr and managed both groups with standardized ventilatory protocols for 48 hr. PIP, mean airway pressure (Paw) and blood gases(AEG) were averaged over 48 hr. Sequential analyses of development of air leaks(AL), intraventricular hemorrhage(IVH) or death during the 48 hr,and chronic lung disease (CLD=ventilator >28 days)were performed.
Subsequent assisted ventilation and O2 suppl. were comparable. Bronchoscopies(n=5) revealed no evidence of necrotizing tracheobronchitis. We conclude that 48 hr of HFJV: 1) maintained or improved ABG at lower Paw; 2) did not eliminate AL or CLD; 3) caused no apparent increase in adverse effects. This first randomized HFV trial indicates a comparable outcome to CV; larger trials will ultimately reveal if HFV is superior. ALA Ohio, ALANO
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Carlo, W., Chatburn, R. & Martin, R. 1358 PRELIMINARY RESULTS OF A RANDOMIZED TRIAL OF HIGH FREQUENCY JET VENTILATION(HFJV) VS CONVENTIONAL VENTILATION(CV) IN SEVERE RESPIRATORY DISTRESS SYNDROME. Pediatr Res 19, 337 (1985). https://doi.org/10.1203/00006450-198504000-01382
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DOI: https://doi.org/10.1203/00006450-198504000-01382