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Randomized trial of high-frequency oscillatory ventilation versus conventional ventilation: effect on systemic blood

David A Osborn1, Nick Evans

  • 1Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia. david.osborn@email.cs.nsw.gov.au

The Journal of Pediatrics
|September 13, 2003
PubMed

Insights

High-frequency oscillatory ventilation (HFOV) did not adversely affect systemic blood flow in very preterm infants during the first 24 hours. This ventilation strategy showed no significant differences in superior vena cava flow or right ventricular output compared to conventional ventilation.

Area of Science:

  • Neonatal physiology
  • Respiratory support in preterm infants
  • Cardiovascular assessment in neonates

Background:

  • Low superior vena cava (SVC) flow in very preterm infants is linked to periventricular hemorrhage and disability.
  • Effective circulatory support is crucial in the first day of life for these vulnerable infants.

Purpose of the Study:

  • To compare the effects of high-frequency oscillatory ventilation (HFOV) versus conventional ventilation (CV) on SVC flow and right ventricular output.
  • To assess the safety of HFOV regarding systemic blood flow in extremely preterm neonates.

Main Methods:

  • Randomized controlled trial involving 45 infants <29 weeks gestational age, randomized to HFOV or CV before 1 hour of age.
  • Echocardiography performed at 3, 10, and 24 hours to measure SVC flow and right ventricular output.
  • Intervention protocol for low SVC flow or hypotension included volume and inotropes.

Main Results:

  • No significant differences in mean SVC flow or right ventricular output between HFOV and CV groups at 3, 10, or 24 hours.
  • A trend towards lower SVC flow and increased need for volume/inotropes in the HFOV group, though not statistically significant.
  • HFOV group showed higher upper body vascular resistance at 10 hours and mean blood pressure at 24 hours.

Conclusions:

  • High-frequency oscillatory ventilation (HFOV) demonstrated no significant adverse effects on systemic blood flow in very preterm infants within the first 24 hours of life.
  • HFOV may be a safe alternative to conventional ventilation for maintaining circulatory parameters in this population.
Abstract

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