Abstract
Over a 10 month period 8 newborns (gestational ages 27-36 weeks, birthweights 770-3440 g and postnatal ages 2-16 d) were treated with HFJV for severe respiratory failure unresponsive to conventional mechanical ventilation (CMV). Diagnoses included tension pulmonary interstitial emphysema (PIE)-4, congenital diaphragmatic hernia (CDH)-2, and intractable pneumothoraees (PTX)-2.
The Sechrist 990 High Frequency Jet Ventilator, a pulse-generated, solenoid-driven respirator was used. This device delivers a volume of gas at a controlled FiO2 and pressure to a jet located in the patient connector proximal to a standard single lumen endotracheal tube. The total volume of gas delivered to the lungs is comprised of the volume flowing through the jet and an additional volume entrained by the venturi effect. In most cases a Sechrist IV-100B was connected in tandem to provide low IMV CMV and improved humidifieation.
Though only 2 of the 8 survived (one CDH, one PTX), all infants displayed marked short-term benefits from HFJV. Mean airway pressures could be lowered considerably without adverse effects on ventilation or oxygenation and with improvement in hemodynamic parameters. Radiographic improvement in PIE was noted in all 4 patients; elective paralysis could be discontinued in 7 of 8. None of the non-survivors displayed evidence of necrotizing tracheobronchitis.
These preliminary results suggest short-term benefits of HFJV in severe respiratory failure. Further studies examining the use of HFJV earlier in the course of neonatal respiratory disease appear indicated.
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Donn, S., Nieks, J. & Bandy, K. 1376 EARLY CLINICAL EXPERIENCE WITH PROXIMAL HIGH - FREQUENCY JET VENTILATION (HFJV) IN NEWBORNS. Pediatr Res 19, 340 (1985). https://doi.org/10.1203/00006450-198504000-01400
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DOI: https://doi.org/10.1203/00006450-198504000-01400