Increased intra-abdominal pressure reduces diaphragmatic motion and results in decreased compliance of the chest wall in infants with acute abdominal pathology or after reduction of viscera that developed outside the abdominal cavity. HFJV provides good gas exchange at low airway pressures; thus we hypothesized that it may be more effective than conventional ventilation in this setting. 20 infants with respiratory and circulatory compromise due to high intra-abdominal pressure were treated with HFJV: 7 had diaphragmatic hernia, 7 NEC, 3 gastroschisis and 3 omphalocele. Data on airway pressures, gas exchange, blood pressure and heart rate were collected for 6 h prior to and 12 h after initiation of HFJV. Each patient served as his own control. ANOVA for repeated measures was used for analysis.Table

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⊗p<0.01; * p<0.0001; ⋄ p=0.05; Data are mean±SD. BAse = last pre-HFJV value.

Conclusions: HFJV results in improved gas exchange at lower airway pressures and less hemodynamic compromise in this high-risk population.