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High-frequency oscillatory ventilation in term and near-term infants with acute respiratory failure: early rescue use.
Am J Perinatol. 2006 Oct; 23(7):403-11.AJ

Abstract

This study describes a high-frequency oscillatory ventilation (HFOV) protocol for term and near-term infants with acute respiratory failure (ARF) and reports results of its prospective application. Neonates, with gestational age >or= 34 weeks, were managed with HFOV, if required, on conventional ventilation (CV), a fraction of inspired oxygen (F IO(2)) 0.5, and a mean airway pressure > 10 cm H (2)O to maintain adequate oxygenation or a peak inspiratory pressure > 24 cm H (2)O to maintain tidal volume between 5 and 7 mL/kg of body weight. Seventy-seven infants (gestational age, 37 +/- 2,3 weeks), received HFOV after a mean duration of CV of 7.5 +/- 9.7 hours. Arterial blood gases, oxygenation index (OI), and alveolar-arterial difference in partial pressure of oxygen (P AO(2) - Pa O(2)) were recorded prospectively before and during HFOV. There were a rapid and sustained decreases in mean airway pressure (MAP), F IO(2), OI, and P AO(2) - Pa O(2) during HFOV (P <or= 0.01). Seventy infants (91%) were weaned successfully from HFOV. Seven infants (P AO(2) - Pa O(2) prior to HFOV, 601 +/- 89 mm Hg) were classified as having experienced treatment failure and died from their underlying disease. Treatment failure was associated with lack of improvement in P AO(2) - Pa O(2) at 1 hour of HFOV (P < 0.01). Early rescue intervention with HFOV is an effective protocol for term and near-term infants with ARF. Failure to improve P AO(2) - Pa O(2) rapidly on HFOV is associated with HFOV failure. Randomized controlled trials are needed to identify benefits of HFOV versus conventional modes of mechanical ventilation.

Authors+Show Affiliations

Pediatric and Neonatal Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17001556

Citation

Ben Jaballah, Nejla, et al. "High-frequency Oscillatory Ventilation in Term and Near-term Infants With Acute Respiratory Failure: Early Rescue Use." American Journal of Perinatology, vol. 23, no. 7, 2006, pp. 403-11.
Ben Jaballah N, Mnif K, Khaldi A, et al. High-frequency oscillatory ventilation in term and near-term infants with acute respiratory failure: early rescue use. Am J Perinatol. 2006;23(7):403-11.
Ben Jaballah, N., Mnif, K., Khaldi, A., Bouziri, A., Belhadj, S., & Hamdi, A. (2006). High-frequency oscillatory ventilation in term and near-term infants with acute respiratory failure: early rescue use. American Journal of Perinatology, 23(7), 403-11.
Ben Jaballah N, et al. High-frequency Oscillatory Ventilation in Term and Near-term Infants With Acute Respiratory Failure: Early Rescue Use. Am J Perinatol. 2006;23(7):403-11. PubMed PMID: 17001556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-frequency oscillatory ventilation in term and near-term infants with acute respiratory failure: early rescue use. AU - Ben Jaballah,Nejla, AU - Mnif,Khaled, AU - Khaldi,Ammar, AU - Bouziri,Asma, AU - Belhadj,Sarra, AU - Hamdi,Asma, Y1 - 2006/09/25/ PY - 2006/9/27/pubmed PY - 2007/2/13/medline PY - 2006/9/27/entrez SP - 403 EP - 11 JF - American journal of perinatology JO - Am J Perinatol VL - 23 IS - 7 N2 - This study describes a high-frequency oscillatory ventilation (HFOV) protocol for term and near-term infants with acute respiratory failure (ARF) and reports results of its prospective application. Neonates, with gestational age >or= 34 weeks, were managed with HFOV, if required, on conventional ventilation (CV), a fraction of inspired oxygen (F IO(2)) 0.5, and a mean airway pressure > 10 cm H (2)O to maintain adequate oxygenation or a peak inspiratory pressure > 24 cm H (2)O to maintain tidal volume between 5 and 7 mL/kg of body weight. Seventy-seven infants (gestational age, 37 +/- 2,3 weeks), received HFOV after a mean duration of CV of 7.5 +/- 9.7 hours. Arterial blood gases, oxygenation index (OI), and alveolar-arterial difference in partial pressure of oxygen (P AO(2) - Pa O(2)) were recorded prospectively before and during HFOV. There were a rapid and sustained decreases in mean airway pressure (MAP), F IO(2), OI, and P AO(2) - Pa O(2) during HFOV (P <or= 0.01). Seventy infants (91%) were weaned successfully from HFOV. Seven infants (P AO(2) - Pa O(2) prior to HFOV, 601 +/- 89 mm Hg) were classified as having experienced treatment failure and died from their underlying disease. Treatment failure was associated with lack of improvement in P AO(2) - Pa O(2) at 1 hour of HFOV (P < 0.01). Early rescue intervention with HFOV is an effective protocol for term and near-term infants with ARF. Failure to improve P AO(2) - Pa O(2) rapidly on HFOV is associated with HFOV failure. Randomized controlled trials are needed to identify benefits of HFOV versus conventional modes of mechanical ventilation. SN - 0735-1631 UR - https://www.unboundmedicine.com/medline/citation/17001556/High_frequency_oscillatory_ventilation_in_term_and_near_term_infants_with_acute_respiratory_failure:_early_rescue_use_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2006-951289 DB - PRIME DP - Unbound Medicine ER -