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High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure.
Pediatr Crit Care Med. 2006 Jul; 7(4):362-7.PC

Abstract

OBJECTIVE

To evaluate the effectiveness of high-frequency oscillatory ventilation (HFOV) in pediatric patients with acute respiratory failure, failing conventional ventilation.

DESIGN

A prospective, clinical study.

SETTING

Tertiary care pediatric intensive care unit.

PATIENTS

Twenty pediatric patients (ages 12 days to 5 yrs) with acute respiratory failure (pneumonia, 14; sepsis with acute respiratory distress syndrome, 3; pulmonary edema as a complication of upper airway obstruction, 2; salicylate intoxication with acute respiratory distress syndrome, 1), failing conventional ventilation (median alveolar-arterial oxygen difference [P(A-a)O2] 578 [489-624] torr, median oxygenation index 26 [21-32].

INTERVENTIONS

HFOV was instituted after a median length of conventional ventilation of 15.5 (3.3-43.5) hrs.

MEASUREMENTS AND MAIN RESULTS

Ventilator settings, arterial blood gases, oxygenation index, and P(A-a)O2 were recorded before HFOV (0 hrs) and at predetermined intervals during HFOV and compared using the one-way Friedman rank-sum procedure and a two-tailed Wilcoxon matched-pairs test. Initiation of HFOV caused a significant decrease in FiO2 at 1 hr that continued to 24 hrs (p <or= .04). In all patients, target ventilation was achieved, and 19 had improved oxygenation. After 1 hr, PaCO2 significantly decreased (p = .002) and remained within the target range thereafter. There were significant decreases in P(A-a)O2 and oxygenation index at 1 and 4 hrs, respectively, that were sustained up to 12 hrs (p <or= .04). No significant complications associated with HFOV were detected. Fifteen patients (75%) survived to hospital discharge. Only one patient died from respiratory failure.

CONCLUSIONS

In pediatric patients with acute respiratory failure, failing conventional ventilation, HFOV improves gas exchange in a rapid and sustained fashion. However, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.

Authors+Show Affiliations

Ben Jaballah N
Pediatric Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia.
Khaldi A
No affiliation info available
Mnif K
No affiliation info available
Bouziri A
No affiliation info available
Belhadj S
No affiliation info available
Hamdi A
No affiliation info available
Kchaou W
No affiliation info available

MeSH

Acute DiseaseChild, PreschoolFemaleHigh-Frequency VentilationHumansInfantInfant, NewbornMaleProspective StudiesPulmonary Gas ExchangeRespiratory Distress SyndromeRespiratory InsufficiencySurvival Analysis

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16738496

Citation

Ben Jaballah, Nejla, et al. "High-frequency Oscillatory Ventilation in Pediatric Patients With Acute Respiratory Failure." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 7, no. 4, 2006, pp. 362-7.
Ben Jaballah N, Khaldi A, Mnif K, et al. High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. Pediatr Crit Care Med. 2006;7(4):362-7.
Ben Jaballah, N., Khaldi, A., Mnif, K., Bouziri, A., Belhadj, S., Hamdi, A., & Kchaou, W. (2006). High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 7(4), 362-7.
Ben Jaballah N, et al. High-frequency Oscillatory Ventilation in Pediatric Patients With Acute Respiratory Failure. Pediatr Crit Care Med. 2006;7(4):362-7. PubMed PMID: 16738496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. AU - Ben Jaballah,Nejla, AU - Khaldi,Ammar, AU - Mnif,Khaled, AU - Bouziri,Asma, AU - Belhadj,Sarra, AU - Hamdi,Asma, AU - Kchaou,Wassim, PY - 2006/6/2/pubmed PY - 2006/9/22/medline PY - 2006/6/2/entrez SP - 362 EP - 7 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 7 IS - 4 N2 - OBJECTIVE: To evaluate the effectiveness of high-frequency oscillatory ventilation (HFOV) in pediatric patients with acute respiratory failure, failing conventional ventilation. DESIGN: A prospective, clinical study. SETTING: Tertiary care pediatric intensive care unit. PATIENTS: Twenty pediatric patients (ages 12 days to 5 yrs) with acute respiratory failure (pneumonia, 14; sepsis with acute respiratory distress syndrome, 3; pulmonary edema as a complication of upper airway obstruction, 2; salicylate intoxication with acute respiratory distress syndrome, 1), failing conventional ventilation (median alveolar-arterial oxygen difference [P(A-a)O2] 578 [489-624] torr, median oxygenation index 26 [21-32]. INTERVENTIONS: HFOV was instituted after a median length of conventional ventilation of 15.5 (3.3-43.5) hrs. MEASUREMENTS AND MAIN RESULTS: Ventilator settings, arterial blood gases, oxygenation index, and P(A-a)O2 were recorded before HFOV (0 hrs) and at predetermined intervals during HFOV and compared using the one-way Friedman rank-sum procedure and a two-tailed Wilcoxon matched-pairs test. Initiation of HFOV caused a significant decrease in FiO2 at 1 hr that continued to 24 hrs (p <or= .04). In all patients, target ventilation was achieved, and 19 had improved oxygenation. After 1 hr, PaCO2 significantly decreased (p = .002) and remained within the target range thereafter. There were significant decreases in P(A-a)O2 and oxygenation index at 1 and 4 hrs, respectively, that were sustained up to 12 hrs (p <or= .04). No significant complications associated with HFOV were detected. Fifteen patients (75%) survived to hospital discharge. Only one patient died from respiratory failure. CONCLUSIONS: In pediatric patients with acute respiratory failure, failing conventional ventilation, HFOV improves gas exchange in a rapid and sustained fashion. However, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/16738496/High_frequency_oscillatory_ventilation_in_pediatric_patients_with_acute_respiratory_failure_ DB - PRIME DP - Unbound Medicine ER -