Abstract
Objective: Neonatal infants with severe respiratory failure have no response to conventional mechanical ventilation (CMV). Our goal was to evaluate the efficacy of high-frequency oscillatory ventilation (HFOV) for treatment of these infants.
Methods: From December 1998 to December 2003, 66 infants with respiratory failure and not responsive to CMV were treated with HFOV. The primary efficacy variables were improvement in oxygenation, lung function, complications and survival. Gestational age of the studied infants was 38°À 5 wk and birth weight 2.9°À 0.6 kg, and first treated with CMV at 20.9°À 4.6 h of postnatal life, and shifted to HFOV at 62.8°À 12.4 h.
Results: After 3 h of HFOV, PaO2/FiO2 and a/A were significantly improved from 50.6°À 4.5 to 88.5°À 9.8 and 0.08°À 0.02 to 0.15°À 0.08, respectively. Oxygenation index (OI) and PaCO2 were rapidly decreased from 30°À 9 to 17°À 5 and 56.6°À 8.9 to 43.4°À 9.4, respectively (p<0.01). These parameters were further improved at 9, 12, 24 and 48 h of HFOV. After 12 h of HFOV, the tidal volumes and dynamic compliance of 46 infants were significantly improved from 3.1°À 0.9 to 4.2°À 1.8 and from 0.89°À 0.8 to 1.36°À 1.44, respectively, and were further improved at 24 and 48 h of HFOV (p<0.05). The survival of all the patients was 81%. The high survivals were found in the patients with meconium aspiration syndrome (17/18), pulmonary interstitial emphysema with air leak (9/9), and respiratory distress syndrome (RDS) whose birth weight >1500g (20/23). Complications were found in those infants with birth weight <1500g, including 6 with ventricular hemorrhage, 3 with pulmonary interstitial emphysema and 1 with hypotension.
Conclusion: Our data suggested that improved HFOV effects in neonates with respiratory failure deserve further investigation on whether if it should be used alternative of CMV.
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Liu, X., Huang, H. & Shenzhen, C. 159 Efficacy of High-Frequency Oscillatory Ventilation for Treatment of Severe Respiratory Failure in Neonates. Pediatr Res 56, 491 (2004). https://doi.org/10.1203/00006450-200409000-00182
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DOI: https://doi.org/10.1203/00006450-200409000-00182