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High-frequency oscillatory ventilation and extracorporeal membrane oxygenation for the treatment of acute neonatal respiratory failure.
Pediatrics. 1990 Feb; 85(2):159-64.Ped

Abstract

Forty-six (92%) outborn and four (8%) inborn term or near-term neonates were admitted for extracorporeal membrane oxygenation (ECMO) treatment to a neonatal intensive care unit between July 1, 1985, and November 1, 1987. All infants had PAO2-PaO2 greater than or equal to 600 mm Hg in spite of aggressive conventional ventilatory and pharmacologic therapy. All patients were offered rescue treatment with high-frequency oscillatory ventilation (HFOV), and only if there was no improvement in PAO2-PaO2 with HFOV were infants treated using ECMO. Four patients died before receiving an adequate trial of HFOV and before emergency ECMO support could be initiated; 21 patients, all of whom survived to hospital discharge, responded to HFOV; 25 patients ultimately required ECMO therapy for cardiopulmonary support, with 22 (88%) surviving to discharge. Neonates responding to HFOV were of slightly younger gestational age (38 +/- 2 weeks vs 40 +/- 2 weeks, mean +/- SD; P less than .001) and more frequently had clinical evidence of pneumonia (11 of 21 vs 2 of 25; P less than .002). There was no statistically significant difference in outcome with respect to the number of ventilator days, hospital days, or survival between patients responding to HFOV and patients who required ECMO. Morbidity was increased in ECMO patients, with bleeding abnormalities, seizures, and renal failure occurring more frequently than in HFOV-treated infants. Overall, 92% (46 of 50) of the patients were treated with a staged protocol using HFOV before ECMO. A total of 46% (21 of 46) responded to HFOV treatment alone and did not require ECMO therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Wilford Hall USAF Medical Center, Lackland AFB, Texas 78236-5000.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

2296503

Citation

Carter, J M., et al. "High-frequency Oscillatory Ventilation and Extracorporeal Membrane Oxygenation for the Treatment of Acute Neonatal Respiratory Failure." Pediatrics, vol. 85, no. 2, 1990, pp. 159-64.
Carter JM, Gerstmann DR, Clark RH, et al. High-frequency oscillatory ventilation and extracorporeal membrane oxygenation for the treatment of acute neonatal respiratory failure. Pediatrics. 1990;85(2):159-64.
Carter, J. M., Gerstmann, D. R., Clark, R. H., Snyder, G., Cornish, J. D., Null, D. M., & deLemos, R. A. (1990). High-frequency oscillatory ventilation and extracorporeal membrane oxygenation for the treatment of acute neonatal respiratory failure. Pediatrics, 85(2), 159-64.
Carter JM, et al. High-frequency Oscillatory Ventilation and Extracorporeal Membrane Oxygenation for the Treatment of Acute Neonatal Respiratory Failure. Pediatrics. 1990;85(2):159-64. PubMed PMID: 2296503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-frequency oscillatory ventilation and extracorporeal membrane oxygenation for the treatment of acute neonatal respiratory failure. AU - Carter,J M, AU - Gerstmann,D R, AU - Clark,R H, AU - Snyder,G, AU - Cornish,J D, AU - Null,D M,Jr AU - deLemos,R A, PY - 1990/2/1/pubmed PY - 2001/3/28/medline PY - 1990/2/1/entrez SP - 159 EP - 64 JF - Pediatrics JO - Pediatrics VL - 85 IS - 2 N2 - Forty-six (92%) outborn and four (8%) inborn term or near-term neonates were admitted for extracorporeal membrane oxygenation (ECMO) treatment to a neonatal intensive care unit between July 1, 1985, and November 1, 1987. All infants had PAO2-PaO2 greater than or equal to 600 mm Hg in spite of aggressive conventional ventilatory and pharmacologic therapy. All patients were offered rescue treatment with high-frequency oscillatory ventilation (HFOV), and only if there was no improvement in PAO2-PaO2 with HFOV were infants treated using ECMO. Four patients died before receiving an adequate trial of HFOV and before emergency ECMO support could be initiated; 21 patients, all of whom survived to hospital discharge, responded to HFOV; 25 patients ultimately required ECMO therapy for cardiopulmonary support, with 22 (88%) surviving to discharge. Neonates responding to HFOV were of slightly younger gestational age (38 +/- 2 weeks vs 40 +/- 2 weeks, mean +/- SD; P less than .001) and more frequently had clinical evidence of pneumonia (11 of 21 vs 2 of 25; P less than .002). There was no statistically significant difference in outcome with respect to the number of ventilator days, hospital days, or survival between patients responding to HFOV and patients who required ECMO. Morbidity was increased in ECMO patients, with bleeding abnormalities, seizures, and renal failure occurring more frequently than in HFOV-treated infants. Overall, 92% (46 of 50) of the patients were treated with a staged protocol using HFOV before ECMO. A total of 46% (21 of 46) responded to HFOV treatment alone and did not require ECMO therapy.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/2296503/High_frequency_oscillatory_ventilation_and_extracorporeal_membrane_oxygenation_for_the_treatment_of_acute_neonatal_respiratory_failure_ DB - PRIME DP - Unbound Medicine ER -