Abstract 1106 Neonatology: Clinical Investigation Platform, Monday, 5/3

High frequency oscillatory ventilation (HFOV) is utilized to rescue newborn infants with severe respiratory failure when conventional mechanical ventilation (CMV) fails to produce adequate oxygenation and ventilation. Despite improved oxygenation which has been extensively reported, there is little information on the vibration-related hazards of HFOV therapy.

Methods: Between April and October 1998, we prospectively studied the vibration produced by HFOV in 7 HFOV-treated neonates (weight: mean 2210 [range 830-4460] g, gestation: 32 [25-41] weeks) and compared that with CMV and of weight-matched controls receiving CMV (n=8, 2150 [640-4620] g, 32 [23-42] weeks) or breathing spontaneously (SB) (n=8, 2060 [540-3500] g, 31 [24-41] weeks). A non-invasive accelerometric sensor was placed at the mid-sternum or postauricular cranium to measure the vibration transmitted to the body and head, respectively.

Results: Significantly higher root-mean-square amplitudes of vibration were detected during HFOV than during CMV (0.098 ± 0.026 vs. 0.017 ± 0.006 g at the chest and 0.011 ± 0.003 vs. 0.007 ± 0.001 g at the cranium, respectively, paired t test) in the HFOV-treated neonates. The intensities of vibration at the chest and post-auricular cranium in HFOV-treated neonates were significantly higher than those of weight-matched controls (ANOVA). The HFOV-induced vibration at the chest in neonates well exceeds the whole-body vibration safe limit for adults, which decreases with increasing duration of exposure. (Figure)

Fig 1
figure 1

No caption

Full size image

Conclusion: HFOV in newborns produces vibration that exceeds adult safe limit. Although no definitive vibration disease is recognized in neonates, adult multi-system disorders related to vibratory stress have been described. Research on safety of HFOV is necessary.