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Efficacy of early piston‐type high‐frequency oscillatory ventilation in infants with respiratory distress syndrome
Author(s) -
Sakai Takeo,
Kamohara Takasi,
Aiba Satoru,
Yoshioka Tosiro,
Itinohe Akiko,
Chiba Hiroo,
Watanabe Tatsuya,
Iinuma Kazuie
Publication year - 2001
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1103
Subject(s) - mean airway pressure , medicine , respiratory distress , high frequency ventilation , neonatal respiratory distress syndrome , mechanical ventilation , anesthesia , continuous positive airway pressure , surfactant therapy , gestational age , pregnancy , biology , obstructive sleep apnea , genetics
We investigated whether the combination of surfactant replacement therapy and early application of high‐frequency oscillatory ventilation (HFOV) was more effective in patients with respiratory distress syndrome (RDS) than late application of HFOV and conventional mechanical ventilation (CMV). To determine this, we retrospectively reviewed the cases of 126 neonates with RDS who received surfactant replacement therapy within 4 hr after birth. Patients were grouped into those who received HFOV immediately after birth (HFOV group), those who initially were ventilated by CMV and subsequently received HFOV (CMV/HFOV group), and those who did not receive HFOV (CMV group). Changes in respiratory system compliance (Crs), arterial‐alveolar oxygen gradient (a/ApO 2 ), and mean airway pressure (MAP) were compared. Infants who received HFOV were less mature than those who received CMV. The a/ApO 2 measured immediately after birth before surfactant replacement therapy was significantly lower in the HFOV and CMV/HFOV group than in the CMV group. After 72 hr, the Crs in the HFOV group was higher than in any other group and was significantly higher than the CMV/HFOV group at 48 and 120 hr. These results suggest that initiating HFOV in combination with surfactant replacement therapy immediately after birth provides effective ventilatory support for infants with RDS. Pediatr Pulmonol. 2001; 32:168–174. © 2001 Wiley‐Liss, Inc.