HIGH-FREQUENCY JET VENTILATION REDUCES CHRONIC LUNG DISEASE; STRATEGY AFFECTS THE INCIDENCE OF ADVERSE OUTCOMES. † 1999

We entered 142 infants with respiratory distress syndrome (RDS) in a randomized study of conventional (CV) vs high-frequency jet ventilation (HFJV) at 8 centers. Infants were eligible if they weighed 700-1500g and required mechanical ventilation with ≥30% O₂ >2h after surfactant. The prescribed high-volume strategy (HI) was used in 34/69 HFJV patients; the rest were treated with standard HFJV strategy: low peak and mean pressure (LO). HI was defined as PEEP ≥ 7cmH₂O or a ≥1cmH₂O PEEP increase from baseline. Continuous variables are expressed as mean±SD. HFJV reduced the incidence of BPD at 36 wks post conceptional age. Unlike Wiswell, et al (AAP Meet. Oct 95), we did not see more adverse outcomes with HFJV. Major IVH/PVL were significantly more frequent in infants treated with LO (the strategy used by Wiswell, et al) than HI. Significantly lower PaCO₂ in LO group suggests a possible mechanism. Table

Table 1