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Individualized lung recruitment during high-frequency ventilation in preterm infants is not associated with lung

Anne P De Jaegere1, Eline E Deurloo2, Rick R van Rijn2

  • 1Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.

European Journal of Pediatrics
|June 22, 2016
PubMed

Insights

Individualized lung recruitment using high-frequency ventilation (HFV) in preterm infants with respiratory distress syndrome (RDS) shows a low risk of lung hyperinflation and air leaks. This approach may improve lung aeration and reduce complications in neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Lung recruitment during high-frequency ventilation (HFV) in preterm infants with respiratory distress syndrome (RDS) carries risks of lung hyperinflation and air leaks.
  • Individualizing recruitment strategies may mitigate these risks based on disease severity.

Purpose of the Study:

  • To evaluate chest X-ray (CXR) findings during individualized oxygenation-guided lung recruitment with HFV in preterm infants with RDS.
  • To assess the incidence of lung hyperinflation and air leaks before and after surfactant therapy.

Main Methods:

  • Prospective cohort study involving 69 preterm infants with RDS undergoing HFV.
  • Chest X-rays were analyzed by two pediatric radiologists for radiolucency, hyperinflation, and air leaks before and after surfactant treatment.
  • An individualized oxygenation-guided recruitment protocol was employed.

Main Results:

  • Following recruitment, 64% of infants had a radiolucency score ≤2, indicating adequate lung aeration.
  • Mild to moderate hyperinflation was observed in 19% of infants, with no air leaks initially.
  • After surfactant, 62% showed improved radiolucency, with mild to moderate hyperinflation in 24% and air leaks in only 6% of patients during the entire admission.

Conclusions:

  • Individualized oxygenation-guided lung recruitment during HFV in preterm infants with RDS is associated with a low risk of significant hyperinflation and air leaks.
  • This approach appears safe and effective in improving lung aeration in this vulnerable population.
Abstract

Keywords:
DiagnosisNeonatal respiratory distress syndromePneumothoraxThoracic radiograph

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