Journal of paediatrics and child health · 1995
High frequency oscillatory ventilation: initial experience in 22 patients.
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Johnston D, Hochmann M, Timms B
Аннотация
OBJECTIVES: To report the outcome of a consecutive cohort of neonates treated with high frequency oscillatory ventilation (HFOV).
METHODOLOGY: Prospective cohort study of 22 neonates failing conventional mechanical ventilation (CMV) between October 1992 and August 1993. Outcomes evaluated were in-hospital survival rate, comorbidities including patent ductus arteriosus (PDA), cerebroventricular haemorrhages (CVH), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), and acute changes in respiratory status.
RESULTS: Eighteen of 22 (81.8%) survived. Of the four children who died, one did not respond to HFOV and died within 24 h of treatment. Two died of respiratory failure complicated by pulmonary haemorrhage. The remaining infant responded to HFOV but later developed severe NEC while on minimal CMV and died at 2 weeks of age. Three subjects were > or = 34 weeks' gestation; each responded well to HFOV with no substantial comorbidity. Of the remaining 19 infants < 34 weeks' gestation, six (31.6%) had a PDA, and seven (36.8%) had a CVH. One infant developed cystic periventricular leucomalacia. Three infants (15.8%) had NEC. Respiratory failure in the 15 survivors with gestational ages < 34 weeks improved dramatically with HFOV. Ten (66.7%) survivors < 34 weeks developed BPD and 10 (66.7%) ROP.
CONCLUSION: High frequency oscillatory ventilation was associated with a survival rate of 81.8%, but with significant comorbidity.
METHODOLOGY: Prospective cohort study of 22 neonates failing conventional mechanical ventilation (CMV) between October 1992 and August 1993. Outcomes evaluated were in-hospital survival rate, comorbidities including patent ductus arteriosus (PDA), cerebroventricular haemorrhages (CVH), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), and acute changes in respiratory status.
RESULTS: Eighteen of 22 (81.8%) survived. Of the four children who died, one did not respond to HFOV and died within 24 h of treatment. Two died of respiratory failure complicated by pulmonary haemorrhage. The remaining infant responded to HFOV but later developed severe NEC while on minimal CMV and died at 2 weeks of age. Three subjects were > or = 34 weeks' gestation; each responded well to HFOV with no substantial comorbidity. Of the remaining 19 infants < 34 weeks' gestation, six (31.6%) had a PDA, and seven (36.8%) had a CVH. One infant developed cystic periventricular leucomalacia. Three infants (15.8%) had NEC. Respiratory failure in the 15 survivors with gestational ages < 34 weeks improved dramatically with HFOV. Ten (66.7%) survivors < 34 weeks developed BPD and 10 (66.7%) ROP.
CONCLUSION: High frequency oscillatory ventilation was associated with a survival rate of 81.8%, but with significant comorbidity.
Предметные рубрики MeSH
BarotraumaBronchopulmonary DysplasiaCohort StudiesFemaleHigh-Frequency VentilationHumansHyaline Membrane DiseaseInfant, Low Birth WeightInfant, NewbornInfant, PrematureIntensive Care, NeonatalMalePartial PressureProspective StudiesPulmonary EmphysemaPulmonary Gas ExchangeRespiration, ArtificialRespiratory Function TestsRespiratory InsufficiencyTidal VolumeTreatment Outcome