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The use of high frequency oscillatory ventilation in a pediatric oncology intensive care unit

Nesreen A Faqih1, Su'ad H Qabba'h, Rawad S Rihani

  • 1Departments of Pediatric Oncology, King Hussein Cancer Centre, Queen Rania Street, Al-Jubeiha, Amman, Jordan. nfaqih@khcc.jo

Pediatric Blood & Cancer
|August 6, 2011
PubMed

Insights

High frequency oscillatory ventilation (HFOV) improved gas exchange in pediatric cancer and post-HSCT patients with ARDS. This therapy offers a useful option for managing these critically ill children, with a majority of survivors successfully discharged.

Area of Science:

  • Pediatric Critical Care Medicine
  • Oncology
  • Respiratory Medicine

Background:

  • Acute Respiratory Distress Syndrome (ARDS) poses significant challenges in pediatric oncology and post-hematopoietic stem cell transplantation (HSCT) patients.
  • High Frequency Oscillatory Ventilation (HFOV) is an established treatment for ARDS in children.
  • The effectiveness of HFOV in this specific high-risk pediatric population required further investigation.

Purpose of the Study:

  • To evaluate the efficacy of HFOV in pediatric patients with cancer or post-HSCT who develop ARDS.
  • To assess the impact of HFOV on gas exchange parameters and clinical outcomes in this cohort.

Main Methods:

  • Retrospective case review of pediatric patients diagnosed with ARDS and treated with HFOV.
  • Inclusion criteria: pediatric cancer and/or allogeneic HSCT recipients.
  • Data collected: demographics, oncological diagnosis, PRISM III scores, ventilator settings, gas exchange (A-a gradient, OI, PaCO2), complications, and outcomes.

Main Results:

  • HFOV significantly decreased the alveolar-arterial oxygen (A-a) gradient within 24 hours (P=0.001).
  • Oxygen Index (OI) generally decreased, with higher values noted in non-survivors.
  • 58% of patients (7 out of 12) were successfully weaned from HFOV and discharged.

Conclusions:

  • HFOV demonstrates effectiveness in improving gas exchange for pediatric patients with cancer and post-HSCT who develop ARDS.
  • HFOV serves as a valuable therapeutic option for managing critically ill children in this vulnerable population.
  • Successful weaning and discharge were achieved in a majority of the studied patients.
Abstract

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